242490 02/24/15 ♦("u,C4N
CITY OF CARMEL, INDIANA VENDOR: 368350
ONE CIVIC SQUARE SADIE M BROCK CHECK AMOUNT: S"""""`176.00"
CARMEL, INDIANA 46032 4369 DECLARATION DRIVE CHECK NUMBER: 242490
yroN Via: INDIANAPOLIS IN 46227 CHECK DATE: 02/24/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4341999 1/30-2/20 176.00 OTHER PROFESSIONAL FE
Sadie Brock
1-30-15
Time in: 9:00
Time out: 1:00
TOTAL TIME: 4.00
TOTAL 4.00 x$11.00/hr Amount Due 44.00
2-6-15
Time in: 10:00
Time out: 4:00
TOTAL TIME: 6.00
TOTAL 6.00 x$11.00/hr Amount Due $66.00
2-20-15
Time in: 10:00
Time out: 4:00
TOTAL TIME: 6.00
TOTAL 6.00 x$11.00/hr Amount Due $66.00
Total this Invoice: 176.00
I
Sadie M. rock
Date: 2/20/2015
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forrn 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.
Payee
SAU.,
Purchase Order No.
Terms
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
`) �d✓l' u Imo- IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
20 ( 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
' ` r 20
Signatu
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund