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251686 11/18/15 Q CITY OF CARMEL, INDIANA VENDOR: 358941 ONE CIVIC SQUARE PETTY CASH -BROOKSHIRE GOLF COUQ19JCK AMOUNT: S"""""'98.94" CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 251686 CHECK DATE: 11/18/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4355300 BALLARD 49.47 ORGANIZATION & MEMBER 1207 4355300 CALVERT 49.47 ORGANIZATION & MEMBER Welcome to Indiana Licensing Page 1 of 1 nd in Online Lr ensing n.. Payment Receipt This page serves as your receipt for this transaction. Your payment will appear on your credit card statement as "STATE OF IN WWW INGOV 800-236-5446 IN". Renewal • Completion of Server Training is required every 3 years. Click here to complete Server Training online • A BMV Operating While Intoxicated (OWI) Check is preformed on every application prior to renewing a permit. Please allow 24 - 48 hours to complete the check before your permit will be renewed. o You may print this receipt and use it to work for 60 days, or until your new permit arrives in the mail.. o This receipt must be printed now. You will not be albe to reproduce it at a later time. o All permit application and renewal fees are now non-refundable. Payment received - thank you. Licensee: BRIAN S. BALLARD License Number: BR1614295 Authorization Code: 939833 Received Date: 11/10/2015 12:39:32 PM Transaction ID: 50787750 Credit Card Number: XXXX XXXX XXXX 3362 Fee Amount: $45.00 Enhanced Fee: $2.50 Instant Fee: $1.97 Total Payment: $49.47 CPrint.Redeipt Online Server Training Renew Another License Logout https:Hmylicense.in.gov/EGov/PaymentResult.aspx?answer=processed&credit_card num... 11/10/2015 Welcome to Indiana Licensing Page 1 of 1 11A, t ; �. @Indiana Online Licensing Payment Receipt This page serves as your receipt for this transaction. Your payment will appear on your credit card statement as "STATE OF IN WWW INGOV 800-236-5446 IN". Renewal • Completion of Server Training is required every 3 years. Click here to complete Server Training online A BMV Operating While Intoxicated (OWI) Check is preformed on every application prior to renewing a permit. Please allow 24 - 48 hours to complete the check before your permit will be renewed. • You may print this receipt and use it to work for 60 days, or until your new permit arrives in the mail.. • This receipt must be printed now. You will not be albe to reproduce it at a later time. • All permit application and renewal fees are now non-refundable. Payment received - thank you. Licensee: MICHAEL D. CALVERT License Number: BR1617292 Authorization Code: 109642 Received Date: 11/10/2015 12:31:45 PM Transaction ID: 50786330 Credit Card Number: XXXX XXXX XXXX 3362 Fee Amount: $45.00 Enhanced Fee: $2.50 Instant Fee: $1.97 Total Payment: $49.47 Prin Receipt Online Server Training Renew Another License Logout https://mylicense.in.gov/EGov/PaymentResult.aspx?answer=processed&credit_card num... 11/10/2015 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)) 11/10/15 B Ballard Permit $49.47 11/10/15 M Calvert Permit $49.47 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 Petty Cash IN SUM OF $ $98.94 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#1T'ITLE AMOUNT Board Members 1207 B Ballard 43-553.00 $49.47 1 hereby certify that the attached invoice(s), or 1207 M Calvert 43-553.00 $49.47 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 Tuesday,Povember 10, 2015 Director, Brooks re Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund