218473 03/25/2013 a MY OP CARMEL, INDIANA VENDOR: 365463 Page 1 of 1
ONE CIVIC SQUARE MATTHEW GREGORY
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CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $107.12
CHECK NUMBER: 218473
CHECK DATE: 3/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 107 . 12 TRAVEL FEES & EXPENSE
PRrSCRISCD BY STATE HOARD Of ACCOUNTS GTNERAL iORY IIG.101{19Bq
MILEAGE CLAIM �(� �� G Ye U Y
To
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO- FOR
(Or ICE,HOARD,DErA.RT&CWT OR 1NSTRUnON)
SPEEDOMETER AUTO AL'aE
DATE FROM TO READING + NATURE OF BUSINESS MITES 1�.5�.S" �
26� POINT POINT START FINISH TRAVELED PER NILE
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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.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is just and correct,that the amount claimed is le ally dua,after allowing all just credits
end that no part of the same has been paid.
Date
e-7 C ` '
C 1 MAR 5 013
6 Z
�5
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.
365463 Gregory, Matthew Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
311/13 Reimb Mileage 1122 -2128/13 $ 107.12
Total $ 107.12
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.
365463 Gregory, Matthew Allowed 20
In Sum of$
$ 107.12
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-7 Reimb 4343000 $ 107.12 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
21-Mar 2013
Signature
$ 107.12 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund