HomeMy WebLinkAbout242532 02/24/15 0/f�qp*R!
a, CITY OF CARMEL, INDIANA VENDOR: 368792
d ONE CIVIC SQUARE STEPHANIE GRIGGS CHECK AMOUNT: $ ...6.12'
?4 CARMEL, INDIANA 46032 C/O LAW CHECK NUMBER: 242532
I!, CHECK DATE: 02/24/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4358300 6.12 OTHER FEES & LICENSES
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Your transaction is complete. Print this receipt for your records. Your receipt identification nu
is 15361291. Please reference this number in any correspondence regarding your transaction
Payer Information
STEPH I e IGGS_
iPhone
I Email
Account Information ?
exp.
Transaction Details
Description UnitQuantityExte
Price Pric
`Duplicate Commission Fee $5.00 1
'Instant Access Fee $1.12 1
Total
The following amounts have been charged to your credit card. Your credit card statement wil
the following merchant name(s) and amount(s) for this transaction.
MerchantAmount
E i
�IN Sec of State 800-236-5446
The total amount charged to your credit card is $6.12.
i
Privacy Statement
https:Hsecure.in.gov/apps/kwikekard/checkout/servlet/receipt?token=ODDODC 14F 1 EB502... 1/29/2015
Prescribed by State Board of 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
Stephanie Griggs
Purchase Order No.
1 Civic Square
Terms
Carmel, Indiana 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2/16/2015 reimbursement for fees associated with Notary $612
per the attached
4 sP
t
d
Total
$6.12
1 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
Stephanie Griggs IN SUM OF $
1 Civic Square
Carmel, Indiana 46032
$ $6.12
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
4358300 Other Fees & Licenses
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
1180 4358300 $6.12 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
rJ 20
Signature
Titl
Cost distribution ledger classification if
claim paid motor vehicle highway fund