242286 02/17/15 CITY OF CARMEL, INDIANA VENDOR: 120301
® ONE CIVIC SQUARE HAMILTON COUNTY TREASURER CHECK AMOUNT: $****12,900.80*
CARMEL, INDIANA 46032 C/O HAMILTON CO AUDITOR CHECK NUMBER: 242286
v r 1 HAMILTON COUNTY SQUARE CHECK DATE: 02/17/15
NOBLESVILLE IN 46060
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 1/31/15 12,900.80 OTHER EXPENSES
PRESCRIBED BY STATE BOARD OF ACCOUNTS CITY AND TOWN FORM 217 CT(1997)
REPORT TO COUNTY AUDITOR OF COURT COSTS
COLLECTED IN CITY/TOWN COURT
To the Auditor of Hamilton County, Indiana
I, Diana L. Cordray, City Officer of the City of Carmel, Indiana, hereby certify that I have received the
=- following amounts of the court costs payable to the County:
a
For the month ending January 31, 2015.
ITEMIZATION COLLECTIONS PRIOR YEAR TO DATE
- - -
T-1-11S PJul
ERIOD COLLECTIONS - -
$0 $12,900.80
COURT COSTS: $12,900.80
TOTAL AMOUNT COLLECTED $0 $12,900.80
$12,900.80
Dated , 2015
City Fiscal Officer
NOTE—Mail To:
Hamilton County Auditor
One Hamilton County Square
Noblesville, IN 46060
(Make check payable to Hamilton County Treasurer)
Prescribed by State 3oard 4f Accounts ACCOUNTS PAYABLE VOUCHER City FormNo.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.
Payee
a� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
MAAA /meq , �/°
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
IN SUM OF $
Lkpo U
$ 4,0 UU. g°
ON ACCOUNT OF APPROPRIATION FOR
6 PA Rt �j
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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
20
-44�4jk-py��
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund