246820 06/30/15 CITY OF CARMEL, INDIANA VENDOR: 120301
d it ONE CIVIC SQUARE HAMILTON COUNTY TREASURER CHECK AMOUNT: $****13,356.00*
s_ a� CARMEL, INDIANA 46032 C/O HAMILTON CO AUDITOR CHECK NUMBER: 246820
.Mlr6N�, 1 HAMILTON COUNTY SQUARE CHECK DATE: 06/30/15
NOBLESVILLEIN 46060
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 MAY COURT 13,356.00 MAY COUNTY COURT COST
PRESCRIBED BY STATE BOARD OF ACCOUNTS CITY AND TOWN FORM 217 CT(1997)
REPORT TO COUNTY AUDITOR OF COURT COSTS
COLLECTED IN CITY/TOWN COURT
To the Auditor of Hamilton County, Indiana
I, Diana L. Cordray, City Officer of the City of Carmel, Indiana, hereby certify that I have received the
following amounts of the court costs payable to the County:
For the month ending MAY 31, 2015.
ITEMIZATION COLLECTIONS PRIOR YEAR TO DATE
THIS PERIOD COLLECTIONS
$54,705.23 $68,061.23
COURT COSTS: $13,356.00
TOTAL AMOUNT COLLECTED $54,705.23 $68,061.23
$13,356.00
T
Dated V , 2015.
r
City Fiscal Officer
NOTE—Mail To:
Hamilton County Auditor
One Hamilton County Square
Noblesville, IN 46060
(Make check payable to Hamilton County Treasurer)
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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 ' voice(s) or bill(s))
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.
LOWED 20
Fo ���
IN SUM OF $
Ulu
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or DEPT.# INVOICE NO. ACCT#!TITLE AMOUNT I hereby certify that the attached invoice(s),
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
0
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund