249893 09/23/15 ,C,�A
''' CITY OF CARMEL, INDIANA VENDOR: 369873
ONE CIVIC SQUARE CARY SHAFER CHECK AMOUNT: $ ..."'425.00"
CARMEL, INDIANA 46032
=0 611 EAST WAYNE ST CHECK NUMBER: 249893
,:.
+;,;,ow.�� FORT WAYNE IN 46602 CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4359000 425.00 SPECIAL PROJECTS
c h shafer
611 east wayne st
fort wayne in 46802
260 615 3855
INVOICE
September 16 2015
Sculpture Delivery Fee $425.00
Thank you
c J�
0
caryshafer@me.com caryshafer.com
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))
09/16/15 Invoice $425.00
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
120
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Cary Shafer
IN SUM OF$
611 East Wayne Street
Fort Wayne, IN 46802
$425.00
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1203 I Invoice I 43-590.00 I $425.00 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
Friday, September 18,2015
Director, Community Relations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund