HomeMy WebLinkAbout253834 01/26/16 t°�'SAM
J;/ �� CITY OF CARMEL, INDIANA VENDOR: 359016 '
li ONE CIVIC SQUARE KAREN BREEDLOVE CHECK AMOUNT: $""""125.00"
'''�rox�jo CARMEL, INDIANA 46032 520 CARMEL SUPER
N 46032T CHECK CHECK DATE: 01/3 63/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 12116 125.00 OTHER EXPENSES
4.
e �y
Cleaning Invoice
Week Date Fee Place
01.21.2016 125.00 Water Dist Office
Please Remit to:
Michelle Breedlove
Backflow Prevention -Cross-Connection Control
Carmel Water Dist Office
3450 W 131St Street
Carmel, IN 46074
(317) 733-2845
Total Due: 125.00
Michelle Breedlove
520 Super Star Ct
Carmel, IN 46032 ff
317-374-1542
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
359016
BREEDLOVE, MICHELLE Purchase Order No.
DISTRIBUTION Terms
Due Date 1/21/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/21/2016 12116 $125.00
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 # 154108 WARRANT# ALLOWED
359016 IN SUM OF $
BREEDLOVE, MICHELLE
DISTRIBUTION
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
12116 01-6360-06 $125.00
Voucher Total $125.00
Cost distribution ledger classification if
claim paid under vehicle highway fund