HomeMy WebLinkAbout249212 09/09/15 CITY OF CARMEL, INDIANA VENDOR: 00351684
ONE CIVIC SQUARE CLERK OF THE COURTS-ANNUAL FEES CHECK AMOUNT: S'"""""180.00'
CARMEL, INDIANA 46032 P 0 BOX 6069 DEPT 179 CHECK NUMBER: 249212
INDIANAPOLIS IN 46206-6069 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4355300 14656 180.00 ULBRIGHT
porwl.courts.l1l.gov
Invoice for Payment by Check
This is an invoice for a payment you owe. Your annual attorney registration is not complete
until your payment is received by the Clerk's Office. Follow the instructions below to remit
payment. .
Please print two (2) copies of this page: submit one copy with your payment and keep the
other copy for your records.
For payment by check: Write your confirmation number(see below) on your check, and
then mail or deliver your check, along with a printed copy of this Invoice, to:
Clerk of the Courts - Annual Fees
P.O. Box 6069 — Dept. 179
Indianapolis, IN 46206-6069
Your payment will be recorded as of the postmark date on the envelope containing your full
payment. Late fees will be due if full payment is not timely submitted.
For payment in cash: Cash payments may be personally delivered 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
Confirmation #:14656
Billing Information
Confirmed: 911/2015
Ashley Marie Ulbricht
(317) 571-2472 aulbricht@carmel.in.gov
Ashley Ulbricht (26930-20)
Annual Fee .............................................. $180.00
Grand Total: $180.00
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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))
9/1/15 14656 Annual Fee -Ashley Ulbricht $180.00
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
Clark of the-Courts
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 1465 435-5300 $180.00 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
i nature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund