HomeMy WebLinkAbout248114 08/04/15 J`(!P!"?*� CITY OF CARMEL, INDIANA VENDOR: 369681
ONE CIVIC SQUARE IGOR BACHKURINSKIY CHECK AMOUNT: $*******335.82*
s =Q CARMEL, INDIANA 46032 11224 BASSWOOD COURT CHECK NUMBER: 248114
'MUTON�o` CARMEL IN 46032-6908 CHECK DATE: 08/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
201 5023990 335.82 INS REFUND-DUP PMT
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Genual Charge/Check Encumbrance/Invoice
i
j -General Transaction Data
li Year 12015 - j Period Control Number
Transaction Dater Date Entered
Transaction Code Transaction Amount 335.82
Vendor/Payer
]ournal EntryNumber
Description 1
Descnption 2
Entered By
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Date TC Year Period SUS-DEPARTMENT Account Description TASK TASK ACCT Amount Indicators
071�8f2015 24"-`!5 ? 20! 396000 `REIhf IGf7RBACKKURINSKIY E 335'.82
02/18,(2015 J 13 15 2 2201
14239031 INS REIM-STATE FARM 335.82
--.. .. ..._...... __..
02/13/2015 24 15 2 201 396010 INS STREET-39031 335.82
__ .-.. ... ........_.............. .... .. _ ..
01/14/2015 13 15 1 2201 4239032 INSURANCE REIM 335.82:
0!/!3/2015 24 15 1 201 396010 INS REIM-STREET39031 335.82
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.199
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
�PUayepeQ ow�"'� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20-
Clerk-Treasurer
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ku no ALLOWED 20
IN SUM OF$
12a� r�ss
8 a
ON ACCOUNT OF APPROPRIATION FOR
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�Q 7, p Board Members
PO#or INVOICE NO. ACCT�#/T'IITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
5,87- 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
Aj
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund