219013 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 364657 Page 1 of 1
ONE CIVIC SQUARE JESSICA RICHARDS CHECK AMOUNT: $20.47
CARMEL, INDIANA 46032 1832 N GLENDORA DR
INDPLS IN 46214 CHECK NUMBER: 219013
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 20 .47 TRAVEL FEES & EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENFAAL FORM IIG.101(Itrebl
MILEAGE CL I T(GOVEAWMENTAL
' r �7 1
UNIT) PPROPRIATION NO. FOR
(OFFICE,BOARD,DEPABTUTIT OR INSTMITION)
SPEEDO ETER
DATE FROM To READI F AUTO
Z-�- POINT POINT START FINISH NATURE OF BUSINESS TR MILES ED ��" y
- � PEA tltE
-- U F S _
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f o cc AnktN S
6 if i .s
3o Ze r-Owe
z 3 1 Foe i 2 25
2 Cc c�-
2 r ti o
D
G
21 D E --- - ' —
MT
PDE(o p C
--- I -IS
0.
AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be delermin d by fix d ileage or official highway.map.
Pursuant to the provisions and penalties of Chapter 255,Acts 1953,I hereby certify that the foregoing acc unt is ju a d correct,that the amount claimed is legally due,after allowing all just w.edits
end that no part of the same has been paid.
Date 3 /aco 13 i
J 1 t
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.
364657 Richards, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
3/26/13 Reimb Mileage 11/28/12 - 3/27/13 $ 20.47
Total $ 20.47
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.
364657 Richards, Jessica Allowed 20
In Sum of$
$ 20.47
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#[TITLE AMOUNT Board Members
Dept#
1081-4 Reimb 4343000 $ 20.47 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
4-Apr 2013
Signature
$ 20.47 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund