HomeMy WebLinkAbout243281 08/12/15 CITY OF CARMEL, INDIANA VENDOR: 00351684
ONE CIVIC SQUARE CLERK OF THE COURTS-ANNUAL FEES CHECK AMOUNT: $'"""`""180.00'
CARMEL, INDIANA 46032 P 0 BOX 6069 DEPT 179 CHECK NUMBER: 248281
INDIANAPOLIS IN 46206-6069 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4355300 13249 180.00 ORGANIZATION & MEMBER
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Confirmation #: 14246
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Fees (Transaction processed at 4:41:08 PM EDT, 8/6/2015)
Douglas Haney(11207-49) Annual Fee $180.00
Total Due $180.00
Instructions
For payment by check IMPORTANT:Write your confirmation number on the memo line of
Write your confirmation number(see below)on your check,and then your check.
mail or deliver your check,along with a printed copy of this "
Invoice,to: John 0.NUD
123 rlsin Street
Szmrnhere,tn&-na 4E=
Clerk of the Courts-Annual Fees (317.-,555-556G date
P.O. Box 6069—Dept. 179Fay'oft.o .Clerk of the.Gouits .Annual Fees
Indianapolis, IN 46206-6069 �'
anomer. c
Your payment will be recorded as of the postmark date on the
envelope containing your full payment.Late fees will be due if full nlema: Confirmation#
payment is not timely submitted.
1=0000.742581: 889.63423ii- .1234»-
For payment in cash
Cash payments may be personally delivered,in exact change only,
with a copy of this Invoice between 8:30 a.m.-4:30 p.m.on regular
business days to the following location:
Clerk of the Courts
402 W.Washington St., Rm.W062
Indianapolis, IN 46204
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https:Hsecure.in.gov/apps/courts/portal/payment/summary 8/6/2015
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHERCity 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
Clerk of Courts -Annual Fees
Purchase Order No.
P. O. Box 6069 - Dept 179
Terms
Indianapolis, Indiana 46206-6069
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
�t
8/6/15 13249 Annual Fee - Douglas Haney
Total
$180.00
1 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
Clerk of theCo,irts IN SUM OF $
PO Box 6069 - Dept. 179
Indianapolis, IN 46206-6069
$ $180.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
4355300 - Organization & Member Dues
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
1180 1324 435-5300 $180.00 or bill(s) is (are) true and correct and that
the materials or services itemized thereon
ifor which charge is made were ordered and
received except
I
+' 20
,,AgI nature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund