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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.
1 Payee
—t.,h 'I&nk bA('6 gW;nes s LIN( Purchase Order No.
41 E Wj6hq:: 11 S+ , 54ff C 2-W Terms
h�1� 6115 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
h�'I inn tis Bu5itress Jmrnkl
IN SUM OF $
,, Sib
� u����n�a.n1►5. T Al 4ti21Y
$ 8 3
�s
ON ACCOUNT OF APPROPRIATION FOR
C� I q3 5 0�(
Board Members
PO#or
DEPT.# INVOICE NO. rAlCCT#//,TITLE AMOUNT I hereby certify that the attached invoice(s),
41 2 5 'I'35 1( 9 3, �j 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
2- 2 2015
igture
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund