251211 11/04/15 +nr_t�gM
CITY OF CARMEL, INDIANA VENDOR: 369238
® tl ONE CIVIC SQUARE ROBERT PATTERSON CHECK AMOUNT: $*****1,500.00*
CARMEL, INDIANA 46032 PO BOX 3159 CHECK NUMBER: 251211
CARMEL IN 46082-3159 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4352500 1,500.00 RENT PAYMENTS
Rental Invoice for 631 Mohawk Ct.
Carmel,, In 46033
For the period from 11/15/2015 to 12/15/2015 $1500.00
Remit to
Robert E. Patterson
P.O. Box 3159
Carmel, In. 46082-3159
VOUCHER NO. WARRANT NO.
ALLOWED 20
Robert E. Patterson
IN SUM OF$
PO Box 3159
Carmel, IN 46082-3159
$1,500.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 102-525.00 $1,500.00 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
NOV 2
Fire Chief
Title
t
Cost distribution ledger classification if
claim paid motor vehicle highway fund 1
ti�
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
iwhom, 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))
$1,500.00
I
I 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