244505 04/21/15 CITY OF CARMEL, INDIANA VENDOR: 369291
ONE CIVIC SQUARE HOOSIER VALUES INC CHECK AMOUNT: S""""'175.00•
CARMEL, INDIANA 46032 17376 TILBURY WAY CHECK NUMBER: 244505
'M�rur WESTFIELD IN 46074-9741 CHECK DATE: 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4350900 JSH003015005 175.00 JSH0030150054
Hoosier Values,Inc. FH A Case No.
FROM:
INVOICE
Hoosier Values,Inc.
INVOICE NUMBER
Hoosier Values,Inc.
17376 Tilbury Way JSH0030150054
Westfield,IN 46074-9741 DATE
04/07/2015
Telephone Number: (317)331-3940 Fax Number: (800)761-0286
REFERENCE
TO: Internal Order#: JSH0030150054
Lender Case#: 25 3rd Ave.SW
Carmel Redevelopment Commission Client File#:
30 W.Main St.,Ste 220
Carmel,IN 46032 Main File#on form: 25 3rd Ave.SW
Other File#on form:
Telephone Number: Fax Number: Federal Tax ID:
Alternate Number; E-Mail:cmeyer@carmel.in.gov Employer ID:
DESCRIPTION
Lender:Carmel Redevelopment Commission Client: Carmel Redevelopment Commission
Purchaser/Borrower: Davis,Richard T.&Mary E.
Property Address:25 3rd Ave SW
City: Carmel
County: Hamilton State: IN Zip: 46032-2060
Legal Description:Acreage.00 Section 25 Township 18 Range 3 1 Mendenhall Lot 8
FEES AMOUNT
2055 175.00
SUBTOTAL 175.00
PAYMENTS AMOUNT
Check#: Date: Description:
Check#: Date: Description:
Check#: Date: Description:
SUBTOTAL 0.00
Make check payable to Hoosier Values,Inc. TOTAL DUE $ 175.00
Form NIV5-"TOTAL'appraisal software by a la made,Inc.-1-800-ALAMODE
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'
X00 iP Va��cn (� Purchase Order No.
l� 7 6 T 1 Il f`_�llfl l/ Terms
VeS+TI e,l tl �, 1V b f I / I I Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7- 1.5 3 OS 2- 5
Sir
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
f" VAI J1 C
okIN SUM OF $
17376 TlAuru -Val
$ 175°0
ON ACCOUNT OF APPROPRIATION FOR,- .
Cc[y� 902 / 4350100
f
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
Z0060 s 0s �I'3Jr0900 7S. "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
I
j
2015
Si na
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund