213867 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 366654 Page 1 of 1
ONE CIVIC SQUARE CALEB SULLIVAN CHECK AMOUNT: $5.65
CARMEL, INDIANA 46032 C/O ESE
*<.o„ CHECK NUMBER: 213867
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 5 . 65 TRAVEL FEES & EXPENSE
PURSCMID IT sun mm OF ACCaWR7 cam"PoW m.IW tWNQ
MILEAGE CLAIM
u ON ACCOUNT OF APMPWAIMO NO: FOR
DATE nom TO RttAD1NQ AUTO _
- PODtT POINT START FUR81I ltA1VHY OF eU�B3tt M ® 11 `•
Pty ttQ.L
AUTO LICt SZ NO. 'TOTAa
+ SPEMMETER READING oolumns 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 11193,I hereby certify that the foregoing account is Just and correct,that the amount claimed in legally due,after allowing all Just credits,
end that no part of the.same baaboon paid.
-757V
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.
Sullivan, Caleb Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
9/28/12 Reimb Mileage 9/28/12 $ 5.65
Total $ 5.65
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. I Warrant No.
Sullivan, Caleb Allowed 20
In Sum of$
$ 5.65
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT WTITL AMOUNT Board Members
Dept#
1081-10 Reimb 4343000 $ 5.65 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
18-Oct 2012
Signature
$ 5.65 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund