HomeMy WebLinkAbout234023 06/25/14 CITY OF CARMEL, INDIANA VENDOR: 368335
j ® Yil ONE CIVIC SQUARE HEATHER GUETWEIN CHECK AMOUNT: $*******775.00*
�9 ?� CARMEL, INDIANA 46032 CHECK NUMBER: 234023
�„TON-� CHECK DATE: 06/25/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 775.00 COBRA REFUND
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
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
Heather Guetwein
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/23/14 06.2
Total
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
20Clerk-Treasurer
VOUCHER NOpg,2W44,—WARRANT NO.
ALLOWED 20
Heather Guetwein IN SUM OF $
I
$ $775.00
ON ACCOUNT OF APPROPRIATION FOR
I
301 Medical Fund
Board Members
PO#or D PT.# INVOICE NO. ACCT#/TITLE AMOUNT 111 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
06.23.14 301 $775.00 f materials or services itemized thereon for
i which charge is made were ordered and
received except
I
0
1
jS,ignature n
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund