217404 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 366937 Page 1 of 1
` ONE CIVIC SQUARE MOLLIE WHITMER
CARMEL, INDIANA 46032 C/O PARKS CHECK AMOUNT: $35.08
.o„ CHECK NUMBER: 217404
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 35 . 08 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAM No.M(IF85)
MILEAGE CLAIM
TO—
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO, FOR
(OMCE,BOARD,DEPARTMENT OR INSTITUTION)_ __ §PEEDOMETER
DATE FROM TO I READING + AUTO MIL
NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED PER MILE
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1 r Ile nfe Lucck�4_ I ( ,&tUXQA DIVCSS�+��l
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rmo - -7,C1
k
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I MOVIon whone
C
-7
AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or,official highway map.
is legally due,after alto U t credits,-
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:_�����al S
and th t art of,the aame has been paid.
Date a no P . I �
oq�
FEB I n13
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.
Whitmer, Mollie Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1/23/13 Reimb. Mileage 10/11 - 11/6/12 $ 35.08
Total $ 35.08
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.
Whitmer, Mollie Allowed 20
In Sum of$
$ 35.08
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#[TITLE AMOUNT Board Members
Dept#
1081-3 Reimb. 4343000 $ 35.08 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
i received except
7-Feb 2013
Signature
$ 35.08 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund