246718 06/30/15 �%" �. CITY OF CARMEL, INDIANA VENDOR: 027290
ONE CIVIC SQUARE ORBIE BOWLES CHECK AMOUNT: $*******'15.00*
''' ® 0 7615 MARY LANE CHECK NUMBER: 246718
:ti ;�; CARMEL, INDIANA 46032 INDIANAPOLIS IN 46217
�,?TON.co. CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 15.00 GASOLINE
c AIL
SPEEDWAY
8885179
Noblesville
IN 46868-3586
(317)773-6136
TRAM# : 2861789
ump 88
n 1 eaded, Self Serve
5 . 883 @ $2 . 999/GAL
AS TOTAL $15 . 88
AX $8 . 88
OTAL $15 . 88
and Num
XXXXXXXXXXX;
ERM : 8858885179881
RANS TYPE : CAPTURE
PPR# : 842589
ATCH # : 99
EQ# f 162899856
NTRY METHOD : ICR
6/11/2815 15 : 25 : 18
ardholder agrees to
ay to issuer total
hanges per the
agreement between
ardholder R issuer .
VISIT US AT
WWW . SPEEDWAY . COM
CUSTOMER SERVICE
1-888-643-1948
-F 8 : 38A-5 : 38P EST
I
t
VOUCHER NO. WARRANT NO.
ALLOWED 20
Orbie Bowles
IN SUM OF $
$15.00
I
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 42-314.00 $15.00 1 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 Ril ll�l t� a0��
1
Fire Chief
` Title
f
Cost distribution ledger classification if
claim paid motor vehicle highway fund
1
,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 service rendered, by
whom, rates per day, number of hours, rate per hour, number,of units, price per unit, etc.
Payee
i
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
Picked up car from Repair Shop and needed gas _ $15.00
I
I
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
120-
Clerk-Treasurer
20Clerk-Treasurer