250755 10/21/15 Coq.
CITY OF CARMEL, INDIANA VENDOR: 353821
ONE CIVIC SQUARE LISA SCOTT CHECK AMOUNT: $*********9.00*
CARMEL, INDIANA 46032 1922 ASHLEY WAY-APT B CHECK NUMBER: 250755
9Mf)pN.G�` WESTFIELD IN 46074 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4239099 9.00 OTHER MISCELLANOUS
r PIGf t
LEE
#15334.1424' S. RANGELINE RU;cg,
CARMEP 4IN 46032
3117 X91-M7 6
l�G'V1 180 4521 0071 10/10/20:15 10 Z2 AM:
(H)SOUR PUNCH TWISTS IIiJ
04136408109 6.00 SALE
2 9 3.29 or 3/9.00
,,- -REGULAR PRICE 3.49 N 1
REWARDS SAVINGS 0.98
RETURN VALUE 3.00 ea =
(S)TOOTSIE..,.CM.APL.,POP;I.5ZWF9:,4Z
07172000315 A 1.00 SALE
1_0_3.29 @„3,.29 o r
REGULAR;:PRICE`3 49
REWARDS'"$AVINGS 0 X49,., ,
—RETURN-VALUE" 00 `
EXCEDRIN 1ENSION CAPLETS 245
30067204524 !. A 6 49 ;
RETURNy`VALUEl'6 49
SUBTOTAL �' 15 49
SALES TAXA
CASH
CHANGE,
BALANCE REWARDS.SAVINGS.
---- .
THANK YOU FOR SHOPPING,,AT,WALGREENS
YOUtOULD`HAVE SAVED'BY USING:-YOUR ,
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APPLY FOR. TERMS AND CONDITIONS, VISIT j
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��CONDITIONS7 VISIT WALGREt14S- COM/BALANCE
RFN# 1533-=471.4-5215151,0 1003`-
, III II III 11111111 I SII,II II III l,llli;l IIII I illi III 1 II II(IIII�IIJI I IIII I li II IIII it Illi: °
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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
Lisa Scott Purchase Order No.
Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
10/10/2015 0 Pumpkin Patch supplies $ 9.00
Total $ 9.00
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.
Lisa Scott ALLOWED 20
IN SUM OF$
$ 9.00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# I hereby certify that the attached invoice(s), or
0 0 2200-4239099 $ 9.00 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
10/19/2015
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund