HomeMy WebLinkAbout231449 04/10/14 r Coq -
` "F CITY OF CARMEL, INDIANA VENDOR: 362339
°I ONE CIVIC SQUARE CITIZENS MANAGEMENT INC CHECK AMOUNT: $*******544.64*
9; oa CARMEL, INDIANA 46032 PO BOX 620
844-0620 CHECK NUMBER: 231449
HO
(TONG CHECK DATE: 04/10/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
302 5023990 03 .31.14 544.64 OTHER EXPENSES
PO Box 620
Howell. MI 48844-0620cmi
11E01111
LOSS FUND INVOICE
TO: MS. SHELLY M. LINGELBAUGH
CITY OF CARMEL
ONE CIVIC SQUARE
CARMEL, IN 46032
03/31/2014
DATE:
LOSS FUND INVOICE
y:
REFERENCE#: E .:';, "AMOUNT DUE UPON RECEIPT"
03/31/2014 ; BALANCE $24,455.,36
AMOUNT.DUE $544.64
IF YOU HAVE ANY QUESTIONS REGARDING THIS BILL PLEASE CONTACT US AT: 517.338.3266
PLEASE NOTE: WE ARE FORBIDDEN BY LAW TO ISSUE CHECK SHOULD YOUR LOSS FUND BECOME ZERO BALANCE.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
CITY OF CARMEL
An invoice or 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
CITIZENS MANAGEMENT INC
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
03/31/14 03.31.14 Loss Fund Invoice
Total
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 NO04lpaL14_WARRANT NO.
ALLOWED 20
CITIZENS MANAGEMENT INC IN SUM OF $
PO Box 620
Howell, MI 48844-0620
$ $544.64
ON ACCOUNT OF APPROPRIATION FOR
302 WORK COMP FUND
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
03.31.14 302 $544.64 materials or services itemized thereon for
which charge is made were ordered and
received except
I 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I