250269 10/17/15 CITY OF CARMEL, INDIANA VENDOR: 00350460
® ONE CIVIC SQUARE MARK HULETT CHECK AMOUNT: S'""'"625.00'
�. ,ice CARMEL, INDIANA 46032 7526 STONEY SIDE LANE CHECK NUMBER: 250269
+,y,_oN,�, INDIANAPOLIS IN 46259 CHECK DATE: 10/07115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357003 24721 3 625.00 AHA CTC
INVOICE
Mark A. Hulett
7526 Stoney Side Lane
Indianapolis, Indiana. 46259
City of Carmel Invoice#03
One Civic Square Invoice Date: 10-1-2015
Carmel, Indiana.46032 Amount Due: $625.00
ITEM DESCRIPTION UNIT COST QUANTITY LINE TOTAL
Carmel Fire Dept. AHA Community Training Center Coordinator $625.00 1 $625.00
Total: $625.00
Amount Due: $625.00
Terms: $625.00 per month for a total of$7500.00 per year
Notes: This invoice is for the monthly payment of September 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))
3 $625.00
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
Mark Hulett
IN SUM OF $
7526 Stoney Side Lane
Indianapolis, IN 46259
$625.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
24721 3 43-570.03 $625.00 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
U e 5 2015
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund