250159 10/07/15 t CITY OF CARMEL, INDIANA VENDOR: 367202
® ONE CIVIC SQUARE CARMEL DRIVE SELF-STORAGE CHECK AMOUNT: S"""'103.00'
CARMEL, INDIANA 46032 550 W CARMEL DRIVE CHECK NUMBER: 250159
•M__oN Eo, CARMEL IN 46032 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1801 4352500 17301 103.00 RENT PAYMENTS
------------------------------------------
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
UNIT DATE ITEM/SERVICE AMOUNT TAX DUE
J201 10/1/2015 Rent 10/1-10/31 103.00 0.00 103.00
J201 11/1/2015 Rent 11/1-11/30 103.00 0.00 103.00
Subtotal 206.00
Taxes 0.00
Balance Due 206.00
Please remit the total due amount of 206.00 to the above address.
REFERRALS PAY OFF! ! ! !! Send your friends and collect your bonus.
RI
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City 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
C di'Mej Drive Self-5hrbP Purchase Order No.
550 6/ (arrnel Dr. Terms
Car mA, I /V q032— Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
17re t 103.00
Total
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
Carmel Drive Sala -5- cage IN SUM OF $
5 Sp W C&r MA nr.
Ckrmc�,T j/ '�Go32
$ IQ .
on
ON ACCOUNT OF APPROPRIATION FOR
J301 1' 3_52_500
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
g 0� I-730 .4352-M 103,00
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
10-5- 2013
Signature
Executive Direc r
Cost distribution ledger classification if Title
g Carmel Redevelopment Commission
claim paid motor vehicle highway fund