213105 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 366561 Page 1 of 1
ONE CIVIC SQUARE BIRGITTA MONSON CHECK AMOUNT: $25.25
CARMEL, INDIANA 46032 245 WILLIMASBURG DR APT 1
THIENSVILLE WI 53092 CHECK NUMBER: 213105
CHECK DATE: 9125/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 25 .25 TRAVEL FEES & EXPENSE
t R Run BOARD OF 6C000NSa
osEMuc raw Jeo.is ttteo
MILEAGE (:LAIN
~ ON'ACCOUNT OF APPROPRIATION NO.�__ FOR
FROM 1O Ab��DIItO+ AUTO MIISAGE
MH
POINT POINT START FINISH NA20RE OF RU93ti838 TRA ® t
I
I
LP e_1 AA
C t1
I-
1OWL Cam-- '-
AUTO LICENSE NO. TOTALS ,` r^
+ SPEEDOME'M 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 1853,I hereby certify that the foregoing rccount is lust and correct,that the amount claimed is legally due,after allowing all lust credits
end that no part of the same has been paid.
Date CJ I 1 1 I Q-
SEP 0 7 2012
D
1
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.
Monson, Birgitta Terms
245 Williamsburg Dr., Apt 1
Thiensville, WI 53092
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/1/12 Reimb Mileage 5/25 -7/26/12 $ 25.25
Total $ 25.25
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.
Monson, Birgitta Allowed 20
245 Williamsburg Dr., Apt 1
Thiensville, WI 53092
In Sum of$
$ 25.25
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-1 Reimb 4343000 $ 25.25 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
20-Sep 2012
Signature
$ 25.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund