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244664 04/29/15 9J^ '�F. CITY OF CARMEL, INDIANA VENDOR: 359016 �i' ONE CIVIC SQUARE KAREN BREEDLOVE CHECK AMOUNT: $*'•""250.00• �; CARMEL, INDIANA 46032 520 SUPER STAR CT CHECK NUMBER: 244664 tr��iori�o• CARMEL IN 46032 CHECK DATE: 04/29/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 41715 250.00 OTHER EXPENSES Cleaning Invoice Week Date Fee Place 4.17.2015 125.00 Water Dist. Office Please Remit to: Michelle Breedlove Backflow Prevention -Cross-Connection Control Carmel Water Dist. Office 3450 W 131 st Street Carmel, IN 46074 (317) 733-2845 Total Due: 125.00 46 Mice Breedlove 7255 Testimony Ave 3D Carmel, In 46033 317-281-1463 i 14 Cleaning Invoice Week Date Fee Place 4.23. 2015 125.00 Water Dist. Office Please Remit to: Michelle Breedlove Backflow Prevention -Cross-Connection Control Carmel Water Dist. Office 3450 W 131 t Street Carmel, IN 46074 (317) 733-2845 Total Due: 125.00 4Mic)eljle Breedlove 7255 Testimony Ave 3D Cannel, In 46033 317-281-1463 2 VOUCHER # 151572 WARRANT# ALLOWED 359016 IN SUM OF $ BREEDLOVE, MICHELLE DISTRIBUTION i i Carmel Water Utility j ON ACCOUNT OF APPROPRIATION FOR ` Board members PO# INV# ACCT# AMOUNT Audit Trail Code 41715 01-6360-06 $250.00 I 1 . Ily t i j. 1, Voucher Total $250.00 i. Cost distribution ledger classification if claim paid under vehicle highway fund I I j 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 359016 BREEDLOVE, MICHELLE Purchase Order No. DISTRIBUTION Terms Due Date 4/21/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/21/2015 41715 $250.00 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 Date Officer