245477 05/20/15 CITY OF CARMEL, INDIANA VENDOR: 369405
>_ d ''r ONE CIVIC SQUARE FREEMAN CUSTOM HOMES CHECK AMOUNT: $ 1,600.00"
CARMEL, INDIANA 46032 `0 Box 199 CHECK NUMBER: 245477
,,�._ a, WESTFIELD IN 46074 CHECK DATE: 05/20/15
� �rON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 102.00 REFUND
659 5023990 1,498.00 REFUND
Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER
TO �-ZLEMA4 `nUS7 14D/otS
ADDRESS 1 �a� �� ��S?��f�� Tf�► �!(�0�1Y
Invoice Date Invoice Number Item Amount
'&LL'Lw100 ag.l� 11, C 4J.,«
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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
Mo. Day Yr. Signature Title
I hereby certify that the attached invoice(s), or bill(s), isare)tru and correct and I have audited same in accordance
with IC 5-11-10-1.6.
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACCT.
rr / CARMEL, INDIANA
t—�2Cfsn.��y CiJS'� ����vp�Of
Y. f49
fS7Fit�o L��' �lCol�1`(
Total Amount of Voucher $
Deductions
Amount of Warrant $ oo
Month of7K;7
Acct.
VOUCHER RECORD No.
Collection System
Pumping
Treatment&Disposal
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
Filed
BOYCE FORMS•SYSTEMS 1.800-382-8702 325