248870 08/26/15 `� �,qwF. . CITY OF CARMEL, INDIANA VENDOR: 00351325
d i ONE CIVIC SQUARE DAVID HUFFMAN CHECK AMOUNT: $***"****73.00*
:. _� CARMEL, INDIANA 46032 C/0 STREET DEPARTMENT CHECK NUMBER: 248870
>„/oN�o, C/0 STREET DEPARTMEN CHECK DATE: 08/26/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4358300 REIMB 73.00 OTHER FEES & LICENSES
' Bureau of Motor Vehicles
k i I II I I I I III II I I IIII III II V I I I II
Customer Transaction Receipt
* i"r *
BN y• State Form 51717 (4-04)
F
Branch: VEHICLE SERVICES- REGISTRATIONS(803) Date: 8/18/15 Time: 3:03:24 pm EDT
100 N SENATE AVE
INDIANAPOLIS, IN 46204-2273
Visit ID: 204011427
Visit Customer: CITY OF CARMEL
Transactions
Trans ID (PIN) Trans Type Trans Subtype Amount
253043808 Title- Initial Title Issuance New $36.50
253044317 Registration - New Motor Vehicle Registration New $0.00
253044671 Title- Initial Title Issuance New $36.50
253044974 Registration - New Motor Vehicle Registration New $0.00
Subtotal: $73.00
Sales/Use Tax: $0.00
Credit Applied: $0.00
Totat $73.00
Payment Method CREDIT Amount $ 73.00
Merchant ID 803BMV Card Type VISA Authorization Number 010315
Terminal ID 2UA52319GZ Entry Method K Trans Sequence No 44473778
Batch No 0 Account Number ************8656
Total Due: $73.00
Amount Paid: $73.00
Change Due: $0.00
I
Within 10 business days, you will receive your registration or title through the United States mail. You will be able to track the
progress of your registration or title by using your PIN number listed above when calling the BMV Customer Service Center at
888-myBMV-411 (888-692-6841).
If you have questions or comments, please call our Customer Service Center at 888-myBMV-411.
Please help us improve our service by completing a one-minute customer satisfaction survey. Your responses are completely
confidential. Visit http://www.in.gov/bmvsurvey/start and enter the survey code 204011427 to get started. Thank you.
www.Facebook.com/inbmv www.Twitter.com/inbmv ,... www.myBMV.com
LAI
II VIII IIII IIII(IIIIIII II I11I I Customer Copy
5 1 7 1 7 2 5 3 0 4 4 9 7 4
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Utiase Unline - Account Actwtty Yage 1 of 1
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Details for CHASE CHECKING (...5879)
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Transaction Results (1 -32)for CHASE CHECKING (...5879) Next
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Date Type Description Debit Credit Balance
Pending Misc Debit
Pending Misc.Debit N
Pending Misc.Debit
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Pending Misc.Debit N
Pending Misc Debit N
Pending Misc.Debit LLE IN
Pending ACH Credit Carmel Pay7838 DR DEPOSIT PPD $3,031.47
Pending ACH Credit
Pending ACH Credit
08202015 Debit Can: "` - ----id�NM3Fr.�` "• " '•'t,,;A,a,,,�1i�•
Transaction 8/19
08202015 Debit Card. '
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08202015 Debit Card '
Transaction .
Debit Card I
08202015 Transaction
08/192015 Check
08/192015 W
Transaction 008/19
08/192015 Debit Card IN BMV VEHICLE SER INDIANAPOLIS IN 08/1 $7300
Transaction 8
08/192015 Debit Card _
Transaction
08/192015 Debit Card
Transaction 08/17
08/182015 ACH Debit 793669
08/182015 ACH Debit 5 0200
WEB ID:534690004
08/182015 Debit Card — _
Transaction 8/17
08/182015 Debit Card
Transaction 08/17
08/182015 Debit Card go BMV VEHICLE SER INDIANAPOLIS IN 08/1 $75.00
Transaction 7
08/182015 Debit Card
Transaction
08/182015 Debit Card
Transaction
08/182015 Debit Card
Transaction 8/16
08/182015 Debit Card
Transaction 6 Sim Mom
08/172015 Debit Card
Transaction
08/172015 ACH Debit
08/17/2015 ACH Debit QQ$523
Debit Card
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®2015 JPMorgan Chase 8 Co.
https://resources.chase.com/commonui/J*avascripts/nisi/ui/html/Print.htm1 8/21/2015
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/18/15 $73.00
1 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
Dave Huffman
IN SUM OF $
$73.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT
Board Members
2201 I I 43-583.001 $73.00 1 hereby certify that the attached invoice(s), 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
t 1' /1
/ Ll
c/rf{ y August 24, 2015
Street Commissioner
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund