252783 12/15/15 �,q4R CITY OF CARMEL, INDIANA VENDOR: 368793
® l ONE CIVIC SQUARE MICHAEL SHEEKS CHECK AMOUNT: S"""""""140.48*
i• ,i4 CARMEL, INDIANA 46032 14382 WHISPER WIND DR CHECK NUMBER: 252783
+.y__ON `• CARMEL IN 46032 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4356003 REIMB 140.48 SAFETY ACCESSORIES
i
RTTRACTOR
SUPPLYC2
Tractor_Supply.com
17500 AUSTRIAN PINE WAY
WESTFIELD, IN 46074
317-867-3605
Ticket 64803-------_---- ----
:late: 12/8/15 Time: 1 :24 PM
Store- 431 Resister: 1
Cashier: Laura
Item _ Qty-------.Pr-ice_ Amount
JS SUPERBRIGHT 350 LUMEN CRFE LED ALUM
1123390 1 12.99 12.99
BOOT WETL MUCK 10 BR SN 65
7152002 1 149.99 127.49
r 1Off Discount (15 ) (22.50)
Suhtoia1 140.48
fax 0.00
Total 140.48
--------------
Ruth #:05293C
Change 0.00
I a3ree to Fay tite above amount ar_corr:ing to
my card iss'.,er agreement.
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Customer COPY
VOUCHER NO. WARRANT NO.
ALLOWED 20
Michael Sheeks
IN SUM OF$
C/O One Civic Square
Carmel, IN 46032
$140.48
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1192 43-560.03 $140.48
I hereby certify that the attached invoice(s), or
I I
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
Friday, December 11, 2015
/11� IC-\4 0
Director
Title
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 Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
12/08/15 Mike Sheeks-boots $140.48
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