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251737 11/18/15
+u(_CnxM CITY OF CARMEL, INDIANA VENDOR: 363272 ONE CIVIC SQUARE JAMES SPELBRING CHECK AMOUNT: $*********5.50* :� CARMEL, INDIANA 46032 16233 HOWDEN DRIVE CHECK NUMBER: 251737 9;�TON.��` WESTFIELD IN 46074 CHECK DATE: 11/18/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 110515 5.50 TESTING FEES Kentucky Three-year Driving History Records https:Hsecure.kentucky.gov/PaymentServices.Hosted/Receipt.aspx?car... Kentucky Three-year Driving History Record Thank you for your payment! Summary Confirmation Number.11926298 Account Holder Details Payment Made:11/05/2015 09:06 AM(05:00 UTC) James P Spelbring 16233 Howden Drive Westfield,IN 46074 i i Cart Items j Description Price Quantity Extended Total i = Driving History Record $5.50 1 $5.50 i Payment Method MasterCard Credit Ending With 0821 --- ---- - - - - - - - - -- -- Total $5.50 ©2014 Kentucky Transportation Cabinet-Privacy(http://kentucky.gov/policies/Pages O Back to top /default.aspx)-Security(http://kentubky.gov/policies/Pages/security.aspx)•Disclaimer (http://kentucky.gov/policies/Pages/disclaimer.aspx)-Accessibility(http://kentucky.gov/policies/Pages /accessibi I ity.aspx) sub mifted To' NOV 16 2015 1 of 1 11/5/2015 9:07 AM Capital One-Transactions&Details https:Hservices2.capitalone.com/ui/#/accounts/98f5Od8d598e8ff9dl5... Capita- Transaction Details Description: KY TRANSPORTATION Transaction Date: 11/05/2015 Posted Date: 11/06/2015 Amount: $5.50 Category: Other Services Details: Government Services 1 of 1 11/16/2015 10:26 AM VOUCHER NO. WARRANT NO. ALLOWED 20 JAMES SPELBRING 16233 HOWDEN DRIVE IN SUM OF$ WESTFIELD, IN 46074 $5.50 ON ACCOUNT OF APPROPRIATION FOR PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members 11.05.15 I 43-588.00 I $5.50 1 hereby certify that the attached invoice(s), or 1201 101 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 Monday, November 16, 2015 Barbara Lamb, HR Director Cost distribution ledger classification if claim paid motor vehicle highway fund 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 Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s)or bill(s)) 11/05/15 I 11.05.15 I Reimbursement Kentucky Driving History Record I $5.50 1201 101 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