208709 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 355994 Page 1 of 1
ONE CIVIC SQUARE PAMELA GRIFFITHS CHECK AMOUNT: $170.95
CARMEL, INDIANA 46032 12906 DOUBLE EAGLE DRIVE
CARMEL IN 46033 CHECK NUMBER: 208709
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4343002 05.02.12 170.95 EXTERNAL TRAINING TRA
Prescribed by State Board of Accounts General Form No. 101 (1955)
a A I 13
TO DR.
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DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES, MILEAGE@
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Auto License No.
it TOTALS
"SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due after
allowing all 'ust credits, and that no part of the same has been paid.
Date
i
I
Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
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by law;
That it is based upon statutory authority;
That it is apparently I correct
incorrect
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MILEAGE CLAIM 61 /~7- L TO �i 1 6 1 DR.
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DATE FROM TO
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Auto License No. I TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 1`55, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after
allowing all just credits, and that no part of the same has been paid.
Date Al
Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form:
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
That it is apparently correct
I incorrect
On Account of Appropriation No. for
Disbursing Officer
Allowed 20 (D N
in the sum of o r
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Prescribed b State Board of Accounts
Y General Form No. 101 (1955)
IL
1 /V 1 7D TO RA M C YI- 1714 DR.
(Governmental Unit) MAY '1,2012
On Account of Appropriation No. for
(Office, Board, Department or Institution __J_
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE
2 Point Point Start Finish TRAVELED PER MILE
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Auto License No. 1 TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after
allowing all just cre its, and that no part of the same has been paid.
Date E'!� ,Cl
Claim No. Warrant No. I have excm the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
That it is apparently correct
incorrect
On Account of Appropriation No. for
Disbursing Officer
Allowed 20 0
in the sum of o
cn
t`' O (D
D
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(Board or Corrunission) I 1
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Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/02/12 05.02.12 mileage 11/22/11- 1/26/12 $74.93
05/02/12 05.02.12 mileage 10.10.11- 11. 18.11 $40.52
05/03/12 05.03.12 mileage 2/2/12- 4/20/12 $55.50
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pam Griffiths
IN SUM OF
$170.95
ON ACCOUNT OF APPROPRIATION FOR
IS Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1202 05.02.12 43- 430.02 $74.93 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1202 05.02.12 43- 430.02 $40.52
materials or services itemized thereon for
1202 1 05.03.12 1 43- 430.02 1 $55.50
which charge is made were ordered and
received except
Mon y, May 07, 2012
Director IS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund