247305 07/15/15 ,y " CITY OF CARMEL, INDIANA VENDOR: 369552
V�
® � ONE CIVIC SQUARE LISA HOBART CHECK AMOUNT: $*******100.00*
4' _�; CARMEL, INDIANA 46032 8512 N CABANA DR#107 CHECK NUMBER: 247305
<,;,,, : FISHERS w 46038 CHECK DATE: 07/15/15
ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 GAZEBO REFUND
I
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.
�Palyee
Purchase Order No.
Li- OkE 7 Terms
�+�Sh e—rs Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
i
i
Total 1&29
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.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
g�/� • �Q�d..Y1Lt,d�r�l�7 IN SUM OF $
ON ACCOUNT OF APP,RpPRIATION FOR
- t ff
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
ID _ OZ-3W O /-+0 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
Signature
Cost distribution ledger.classification if Title
claim paid motor vehicle highway fund