247179 07/15/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 367202
ONE CIVIC SQUARE CARMEL DRIVE SELF-STORAGE CHECKAMOUNT: $****■*•*95.00'
CARMEL, INDIANA 46032 550 W CARMEL DRIVE CHECK NUMBER: 247179
CARMEL IN 46032 CHECK DATE: 07/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4341999 16558 95.00 OTHER PROFESSIONAL FE
i
MAKE CHECK PAYABLE TO INVOICE
Carmel Drive Self-Storage
550 W.Carmel Dr
Carmel,IN 46032 Unit J201
317-574-1700 Tenant 52903
Invoice 16558
Invoice Date July 06,2015
Due Date August 01,2015
Amount Due 95.00
CITY OF CARMEL _
c/o:DIANA L CORDRAY �_� Please check box if address is incorrect
ONE CIVIC SQUARE and indicate change.Signature is required
CARMEL IN 46032 to authorize address changes.
Signature
AMOUNT ENCLOSED
----------------------------------------------------------------------------------------
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
UNIT DATE ITEM/SERVICE AMOUNT TAX DUE
J201 8/1/2015 Rent 8/1-8/31 95.00 0.00 95.00
Subtotal 95.00
Taxes 0.00
Balance Due 95.00
Please remit the total due amount of 95.oo to the above address.
REFERRALS PAY OFF!!!!! Send your friends and collect your bonus.
Prescribed by State Board of AccountsACCOUNTS 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 invoice(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.
ALLOWED 20
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#.or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
O�� (� 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
20
dy
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund