243011 03/11/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 369162
ONE CIVIC SQUARE DAN MATTHEWS CHECK AMOUNT: $********40.00*
CARMEL, INDIANA 46032 1760 E 110TH ST -CHECK NUMBER: 243011
INDIANAPOLIS IN 46280 CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 5023990 40.00 REFUND
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AUTHORIZED'SIGNATURE
OTHER
by State Board of Accounts Boyce Forms Systems,Delevllle,IN General Form No.352(REV.1B97)
RECEIPT
CITY,O.F CARMEL A'
GENERAL'.FUND NO. 057471
FUND s
CARMEL,IN DATE
=1VED FROM 4 c-cs.
SUM OFt)eL�RS 1
100. !
CCOUNT OF SCC-F' ' r"� S L d.<O ".I ( C.. '
TTYPE _� �`�"�"e-' �I
)UNT:
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CHECK M.O. 75
AUTHORIZED SIGNATURE
C,CJB.C. OTHER '''
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Dan Matthews �
IN SUM OF$
1760 EAST 110TH STREET
Indianapolis, IN 46280
$40.00
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ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
210 -570.00 $40.00 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
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Monday, March 02, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
03/02/15 Refund for Gun Permit Fee $40.00
� Ck
0
"J
'25
� ,� CP
I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer