246719 06/30/15 0`+u �ggMf CITY OF CARMEL, INDIANA VENDOR: 359016
�; ONE CIVIC SQUARE KAREN BREEDLOVE CHECK AMOUNT: $*******250.00*
r. ?� CARMEL, INDIANA 46032 520 SUPER STAR CT CHECK NUMBER: 246719
9.y�TON�� CARMEL IN 46032 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 62515 250.00 OTHER EXPENSES
Cleaning Invoice
Week Date Fee Place
6.18. 2015 125.00 Water Dist. Office
Please Remit to:
Michelle Breedlove
Backflow Prevention -Cross-Connection Control
Cannel Water Dist. Office
3450 W 131tir Street
Carmel, IN 46074
(317) 733-2845
Total Due: 125.00
M&elleBrcedlove
7255 Testimony Ave
3D
Cannel, In 46033
317-281-1463
2
Cleaning Invoice
Week Date Fee Place
6.25.2015 125.00 Water Dist. Office
Please Remit to:
- Michelle Breedlove
Backflow Prevention -Cross-Connection Control
Carmel Water Dist. Office
3450 W 131St Street
Carmel, IN 46074
(317) 733-2845
Total Due: 125.00
Mich le Breedlove
7255 Testimony Ave
3D
Carmel, In 46033
317-281-1463
24
VOUCHER # 152197 WARRANT# j ALLOWED
359016
IN SUM OF $
BREEDLOVE, MICHELLE !
DISTRIBUTION
i
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR !
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1
Board members
,i
PO# INV# ACCT# AMOUNT Audit Trail Code
r
62515 01-6360-06 $250.00
1
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ft
,f
Voucher Total $250.00
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 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 6/23/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/23/2015 62515 $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
G 12-
Date
ZDate Officer