252929 12/29/15 CITY OF CARMEL, INDIANA VENDOR: 370164
® ONE CIVIC SQUARE BRADLEY HAYMAKER CHECK AMOUNT: $ ...*'136.00"
�., ,?Q CARMEL, INDIANA 46032 1269 FROGS LEAP CHECK NUMBER: 252929
°.y_roN�, CICERO IN 46034 CHECK DATE: 12/29/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 651 136.00 OTHER EXPENSES
* . Bureau of Motor Vehicles IIII I I IIII (IIII IIIIIIII I
.*(Lai;. Customer Transaction Receipt
* •BMV State Form 51717 (4-04)
Branch: CARMEL STARS(527) Date: 12/18/15 Time: 1:43:39 pm EDT
12955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 206798248
Visit Customer: BRADLEY ELI HAYMAKER
Transactions
Trans ID (PIN) Trans Type Trans Subtype Amount
257497587 Driver- Renew License Renew $36.00
257497741 Customer-Amend Customer Amend $0.00
257498035 Customer-Voter Registration New $0.00
Subtotal: $36.00
Sales/Use Tax: $0.00
Credit Applied: $0.00
Totat $36.00
Payment Method CREDIT Amount $ 36.00
Merchant ID 527BMV Card Type MASTERCARD Authorization Number 024339
Terminal ID 2UA5311 FT4 Entry Method S Trans Sequence No 53210706
Batch No 0 Account Number ************3031
Total Due: $36.00
Amount Paid: $36.00
Change Due: $0.00
Within 10 business days, you will receive your permanent driver's license or identification card through the United States mail.
You will be able to track the progress of your credential review by visiting www.myBMV.com and logging into your personal
account. If you do not receive your credential within 10 business days or you have questions/comments, please call the BMV
Customer Service Center at 888-myBMV-411 (888-692-6841).
Please help us improve our service by completing a one-minute customer satisfaction survey. Your responses are completely
confidential. Visit http://www.in.gov/bmvsurvey/start and enter the survey code 206798248 to get started. Thank you.
www.Facebook.com/inbmv www.Twitter.com/inbmvwww.myBMV.com
III IIIIIIIIIIIII IIII IIIIIIIIIIIIIIII IIII
Customer Copy
5 1 7 1 7 2 5 7 4 9 8 0 3 5
Page 1 of 1
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
T1996
HAYMAKER, BRAD Purchase Order No.
WASTEWATER PLANT Terms
Due Date 12/21/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/21/201! HAYMAKER, $100.00
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
VOUCHER # 156896 WARRANT # ALLOWED
T1996 IN SUM OF $
HAYMAKER, BRAD
WASTEWATER PLANT
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
HAYMAKER, 01-7040-01 $100.00
NRYAj,RuER, 8mb d I--709c)- i 36.00
)3LOO
Voucher Totale�"U6'
Cost distribution ledger classification if
claim paid under vehicle highway fund
r