252241 12/08/15 r Coq-
'' CITY OF CARMEL, INDIANA VENDOR: 367202
:y
.�; ® •�;• ONE CIVIC SQUARE CARMEL DRIVE SELF-STORAGE CHECK AMOUNT: $**.....103.00'
,. i� CARMEL, INDIANA 46032 550 W CARMEL DRIVE CHECK NUMBER: 252241
9,,,.'ON�` CARMEL IN 46032 CHECK DATE: 12/08/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1801 4352500 17815 103.00 RENT PAYMENTS
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
UNIT DATE ITEM/SERVICE AMOUNT TAX DUE
J201 1/1/2016 Rent 1/1-1/31 103.00 0.00 103.00
Subtotal 103.00
Taxes 0.00
Balance Due 103.00
Please remit the total due amount of 103.00 to the above address.
REFERRALS PAY OFF!! !! ! Send your friends and collect your bonus.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City FormNo.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.
n Payee r C
(�r A1C I Y r) Ve S.1,1 J Ii
r4 r Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) ?
17 8115 i
Total
I 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
&rIN SUM OF $
5Sp ti/: Larm� V
C Nr m e�, I AI �U,32-
$ 103.sn
ON ACCOUNT OF APPROPRIATION FOR
I�UI/�3S`zsoo
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT I herebythat the attached invoice(s),
DEPT.# certify ( )�
g u g S I-f 352500 ob 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
12- 3- 20)s
Signat
Executive rector
Title
Cost distribution ledger classification if Carmel Redevelopment Commission
claim paid motor vehicle highway fund