HomeMy WebLinkAbout235138 07/22/14 �jy_�±q,�� CITY OF CARMEL, INDIANA VENDOR: 361675
`_� CHECK AMOUNT: $'*'""'"105.57'
�- ,• ONE CIVIC SQUARE JEREMY KASHMAN
s rte; CARMEL, INDIANA 46032 13161 HIRSCH LANE,UNIT 302 CHECK NUMBER: 235138
9,�,,_ c FISHERS IN 46037 CHECK DATE: 07/22/14
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4355300 105.57 ORGANIZATION & MEMBER
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Payment received - thank you.
Licensee: Jeremy Michael Kashman
License Number: PE10809065
Authorization Code: 023613
Received Date: 7/11/2014 1:36:07 PM
Transaction ID: 19237742
Credit Card Number: XXXX XXXX
Fee Amount: $100.00
Enhanced Fee: $2.50
Instant Fee: $3.07
Total Payment: $105.57
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https://mylicense.in.gov/EGov/PaymentResult.aspx?answer=processed&credit card numb... 7/11/2014
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
Jeremy Kashman Purchase Order No.
Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
7/11/2014 0 License renewal fee $ 105.57
Total $ 105.57
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
I
VOUCHER NO WARRANT NO.
Jeremy Kashman . ALLOWED 20
IN SUM OF$
I
i.
$ 105.57
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PD#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT# I Hereby certify that the attached invoice(s), or
0 0 2200-4355300 $ 105.57 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
7/21/2014
Sig ture
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund