241461 01/27/15 �,q+. CITY OF CARMEL, INDIANA VENDOR: 368350
`'` CHECK AMOUNT: $*******159.50*
.�; ® �\1• ONE CIVIC SQUARE SADIE M BROCK
r,. ?� CARMEL, INDIANA 46032 4369 DECLARATION DRIVE CHECK NUMBER: 241461
9M,�TON.�` INDIANAPOLIS IN 46227 CHECK DATE: 01/27/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4341999 1/16-1/23 159.50 OTHER PROFESSIONAL FE
Sadie Brock
1/23/15
Time in: 8:45
Time out: 3:15
TOTAL TIME: 6.50
TOTAL 6.50 x$11.00/hr Amount Due 71.50
1/16/15
Time in: 8:00
Time out: 4:00
TOTAL TIME: 8.00
TOTAL 8.00 x$11.00/hr Amount Due $88.00
Total this Invoice: 159.50
Sadie Brock
Date: 1/23/2015
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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.
ayee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
r
Total
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
I� IN SUM OF $
$ 1 �5�
ON ACCOUNT OF APPROPRIATION FOR
I
Board Members
PO#or
DEPT.# INVOICE NO. ACCT#!TITLE AMOUNT 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
1.
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund