252633 12/15/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 370137
ONE CIVIC SQUARE GIBSON COMMERCIAL CONSTRUCTIONCHECK AMOUNT: $********75,00*
CARMEL, INDIANA 46032 3024 RIDGEVIEW DR CHECK NUMBER: 252633
INDIANAPOLIS IN 46226 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
602 5023990 REFUND 75.00 OTHER EXPENSES
PB[scBieso By siwi[BOwPO of Accou Nis _
� SUBJECT TO ALL RULES ACCOUNT No.
29649
_AND REGULATIONS NOW
IN EFFECT OR HERE- CONSUMER'S GUARANTEE DEPOSIT
AFTER ADOPTED. WITH
CARMEL WATER UTILITY
CARMEL, INDIANA 46082 DATE
RECEIVED O F 1 n Y� ( omim-Q A 'r Q a0 �COY\ $ J
r,J_LA-R-S
TO E HELD IN TRU SIIT S A GA ANTEE DEPOSIT FOR PAYMENT OF WATER SERVICE.To BE REFUNDED ON DISCONTINUANCE
OF SERVICE IF AND WHEN.�LL BIL S ARE PAID. /1
KEEP THIS RECEIPT CARMEL WATER UTILITY
By—
ADDRESS O'er
REFUNDEDoG• Sef�' _lA0 �j„��[� APPLIED
,
VOUCHER # 153809 WARRANT# ALLOWED
GIBBON COMMERCI IN SUM OF $
GIBSON COMMERCIAL CONSTRUCTI( 11
i' 3024 RIDGEVIEW DR
INDIANAPOLIS, IN 46226
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT '! Audit Trail Code
4
GIBSON 05-2350-00 $75.00
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Voucher Total $75.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
7
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
GIBSON COMMERCI
GIBSON COMMERCIAL CONSTRUCTION Purchase Order No.
3024 RIDGEVIEW DR Terms
INDIANAPOLIS, IN 46226 Due Date 12/10/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/10/201: GIBSON $75.00
I
I�
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
Date Officer