HomeMy WebLinkAbout246408 06/17/15 CITY OF CARMEL, INDIANA VENDOR: 369485
® ONE CIVIC SQUARE MATTHEW LAFOLLETTE CHECK AMOUNT: $********17.00*
CARMEL, INDIANA 46032 438 EMERSON ROAD CHECK NUMBER: 246408
CARMEL IN 46032 CHECK DATE: 06/17/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 17.00 OTHER EXPENSES
30gas
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* ** * Customer Transaction Receipt
B11f1V* State Form 51717 (4-04)
Branch: CARMEL STARS(527) Date: 6/10/15 Time: 10:32:14 am EDT
12955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 202185858
Visit Customer: MATTHEW DAVID LAFOLLETTE
Transactions
Trans ID (PIN) Trans Tyne Trans Subtype Amount
250170608 Driver-Issue CDL Learner New $17.00
Subtotal: $17.00
Sales/Use Tax: $0.00
Credit Applied: $0.00
Totat $17.00
Payment Method CREDIT Amount $ 17.00
Merchant ID 527BMV Card Type VISA Authorization Number 546852
Terminal ID 8ZSZ9P1 Entry Method S Trans Sequence No 39157054
Batch No 0 Account Number ************7337
Total Due. $17.00
Amount Paid: $17.00
Change Due: $0.00
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Customer Copy
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VOUCHER # 155721 WARRANT # ALLOWED
369425 IN SUM OF $
LAFOLLETTE, MATT
SOUTH PLANT
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Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
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Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
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LAFOLLETTE 01-7040-01 $17.00
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Voucher Total $17.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 shorn, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
369425
LAFOLLETTE, MATT Purchase Order No.
SOUTH PLANT Terms
Due Date 6/10/2015
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
6/10/2015 LAFOLLETTI ; $17.00
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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
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Date Officer