210961 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 366393 Page 1 of 1
ONE CIVIC SQUARE CHRISTIAN MOOR
CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $32.14
CHECK NUMBER: 210961
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 32 . 14 TRAVEL FEES & EXPENSE
PRISCRISM R sum BOARD OF$COCA M 6MW"PORN x0 1W MM
MILEAGE CLAIM C� \j �`/� !V`p�r
F6 � � f' I ON ACt301TtiT OF APPROPRIATION NO _ FO8
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DATti FROM TO ggADptp AUTO
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AUTO L1CKNIM NO. TOTAL4 7 nL { ►.:
+ 3PEP90la1EPSlt 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 1(153,1 hereby certify that the foregoing account is Just and correct,that the amount claimed is legaDy " after showing Jnet credits.-
end that n p of th°(same has been paid. ,
Date 2
I J2.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Moor, Christian Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
6/28/12 Reimb Mileage 5/29 -6/28/12 $ 32.14
Total $ 32.14
1 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.
Moor, Christian Allowed 20
In Sum of$
$ 32.14
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-1 Reimb 4343000 $ 32.14 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
12-Jul 2012
Signature
$ 32.14 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund