236611 09/03/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 368607
ONE CIVIC SQUARE TONY BAUMGARTNER CHECK AMOUNT: $"'""`1,500.00•
CARMEL, INDIANA 46032 3295 E 104ST CHECK NUMBER: 236611
CARMEL IN 46033 CHECK DATE: 09/03/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
659 5023990 1,500.00 REFUND
i
Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE V ER
TO A L)M 6 U7 4 U
ADDRESS 302 07 IU`-I 0/1AA 4,L� �llGo33,
Invoice Date Invoice Number Item Amount
_ co
I 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
a, .,.-7
Mo. Day Yr. Signature Title
I 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.
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACCT.
CARMEL, No.
INDIANA
(� Favor Of
1.
Total Amount of Voucher $
Deductions
Amount of Warrant $ �ZJ C
Month of
I
Acct.
VOUCHER RECORD No.
Collection System
Pumping
Treatment&Disposal
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
Filed
i.
BOYCE FORMS•SYSTEMS 1-800-382-8702 325