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211640 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 366401 Page 1 of 1 ONE CIVIC SQUARE LORNE BAXTER ' CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $13.93 CHECK NUMBER: 211640 CHECK DATE: 8114/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4343000 13 . 93 TRAVEL FEES & EXPENSE P R slue soAW or Acman 6n1nIAL PclM a0.101(1000! MILEAGE CLAIM �.�(Dy—h CJ At ON ACCOUNT OF APPROPWATION NO FOR as FROM To RRADIIJQ AUTO DIdEAQY NATt>RY OF Bt13RiR38 POINT POINT START F=R M im 7 it q Uri to a AUTO LICSNSS NO. TOTS o�5 I 3 `�� V/ + SPEEDOWMM READING columns an to be teed only when distance bahveen points cannot be determined W fixed mileage or official highway map. Nrausnt to the pronW=u and penalties of Chapter 199,Acts 1893,I hereby certify that the foregotag account is just and correct.that the amount claimed is legally due,after Ming all ivat eradits: and that po part of a same has been paid. Date c.� . �'r ) AUG 082012 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. 366401 Baxter, Lorne Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 8/3/12 Reimb Mileage 7/10 -7/26/12 $ 13.93 Total $ 13.93 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. 366401 Baxter, Lorne Allowed 20 In Sum of$ $ 13.93 ON ACCOUNT OF APPROPRIATION FOR 108 - ESE PO#or INVOICE N0. ACCT#/TITLE AMOUNT Board Members Dept# 1082-1 Reimb 4343000 $ 13.93 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 9-Aug 2012 Signature $ 13.93 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund