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HomeMy WebLinkAbout257706 04/22/16 CITY OF CARMEL, INDIANA VENDOR: 361675 ONE CIVIC SQUARE JEREMY KASHMAN CHECK AMOUNT: S********15.00* CARMEL, INDIANA 46032 18567 PILOT MILLS CT CHECK NUMBER: 257706 NOBLESVILLE IN 46062 CHECK DATE: 04/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4231400 025716 15.00 GASOLINE VOUCHER NO. WARRANT NO. JEREMY KASHMAN ALLOWED 20 18567 PILOT MILLS CT IN SUM OF$ NOBLESVILLE, IN 46062 $15.00 ON ACCOUNT OF APPROPRIATION FOR Engineering PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members 025716 I 42-314.00 I $15.00 1 hereby certify that the attached invoice(s), or 2200 201 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 Tuesday,April 19, 2016 i r'er 4w Cost distribution ledger classification if claim paid motor vehicle highway fund 'rescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by rohom, rates per day, number of hours, rate per hour, number of units, price per unit,etc. Payee Purchase Order No. Terms Date Due nvoice Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s)or bill(s)) 04/06/16 025716 City pumps were down;Jeremy drove a City vehicle to INDOT and paid $15.00 2200 201 I for gas 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 e'er Amy . K 2700 "1 00 Ga,s becaua� C4,f P LLr'P s w e-e c1Own. Circle K 2427 2243 N. SR 9 Greenfield IN 46140 y (317)462-6480 Term — - ---- - - - - --- 720000104360102 - -- - -- - Appr : 025716 T - UNLEADED PUMP No. 6.3 Gallons 7.90i:i PRICE/G $1 .899 I OTAL_FLEL $ .5 'SALE Card Num : (S) XXXXXX9291 1-1-4/86/2016 16:58:45 I agree to pay the above Total, Amount according to Card Issuer Agreement. TOTAL SALE $15.00 THANK. YOU -- -- -- - HAVE--A N-ICE_DAY - — - - -- - -