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257687 04/22/16
CITY OF CARMEL, INDIANA VENDOR: 357203 CHECK AMOUNT: $********79.94* ONE CIVIC SQUARE JEFFREY EADS r. r° CARMEL, INDIANA 46032 5671 HARE DRIVE CHECK NUMBER: 257687 NOBLESVILLE IN 46062 CHECK DATE: . 04/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 041616 39.97 OTHER EXPENSES 651 5023990 041616 39.97 OTHER EXPENSES VOUCHER # 161266 WARRANT # ALLOWED 357203 IN SUM OF $ EADS, JEFF Utilities Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 041616 01-6200-07 $39.97 Voucher Total $39.97 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 357203 FADS, JEFF Purchase Order No. Utilities Terms Due Date 4/19/2016 Invoice Invoice Description J Date Number (or note attached invoice(s) or bill(s)) Amount 4/19/2016 041616 $39.97 hereby certify that the attached invoice(s), or bill(s) is (are) true and :orrect and I have audited same in accordance with IC 5-11-10-1.6 nl/""X" Date Officer 4/19/2016 Transaction Details Transaction Details W FORUM"" C R E D I T U N 1 0 N 4/18/2016 Eff.4/16/2016 WITHDRAWAL @ 5311 NORDSTROM RACK#0247 NORD STROM RACK#02 INDIANAPOLIS INUS Trace#1264 5353 -$85.54 Hide Memo/Categorizations MEMO (No memo text) CATEGORIES Uncategorized $85.54 Generated on 4/19/2016 8:10:15 AM @ 2016 FORUM Credit Union.All rights reserved. https./Iwww.forumcuonl i ne.con-VH istoryfPri ntTransacU on 1/1 VOUCHER # 165152 WARRANT# ALLOWED 357203 IN SUM OF $ EADS, JEFF utilities Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 041616 01-7200-07 $39.97 �p Voucher Total $39.97 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 357203 EADS, JEFF Purchase Order No. utilities Terms Due Date 4/19/2016 Invoice Invoice Description Date Number (or note-attached invoice(s) or bill(s)) Amount 4/19/2016 041616 $39.97 hereby certify that the attached invoice(s), or bill(s) is (are) true and :orrect and I have audited same in accordance withIC5-11-10-1.6 q1 al(, Date Officer NORDSTROM rack Rivers Edge 4036 East 82nd Street Indianapolis, IN 46250 (317) 572-2955 tore 247 Reg# 4903 Tran# 4761 - ALE Rng: Amy F. I P MENS DE:410 ATHLETIC FIT ( w 17089537985 49.97 iP MENS DE:511 SLIM FIT SEQUOIA E39027956227 29.97 ompare At 68.00 UBTOTAL 79,94 ALES TAX 5.60 OTAL 85.54 otal Items Purchased = 2 i C 0000000000-0 85.54 ***********6838 S ` I #ou S010: $38.03 Well done, Style Hunter! i *Savings comparison not available for all items i IIIII��IIIIIII�I � I�I�I�IIIII�IIII{Ill �lllll�llilllllll � - 4 40 1046 04/16/2016 05:12 PM Your feedback is extremely valuable. Take a 2 minute survey about your experience at: https://survey.medallia.com/nordsirom Thank you for shopping at Nordstrom Rack Follow us on Twitter Share your finds using #NordstromRack SHOP WITH CONFIDENCE Now you have up to 90 days to make returns and exchanges. 4/19/2016 Transaction Details Transaction Details 14-1-1 FORUNT C R E D 1 7 U N 1 0 N 4/18/2016 Eff.4/16/2016 WITHDRAWAL @ 5311 NORDSTROM RACK#0247 NORDSTROM RACK#02 INDIANAPOLIS INUS Trace #1264 5353 -$85.54 Hide Merno/Categorizations MEMO (No memo text) CATEGORIES Uncategorized $85.54 Generated on 4/19/2016 8:10:15 AM ©2016 FORUM Credit Union.All rights reserved. https://uwwv.forumcuonline.conVHistorVPrintTransaction 1/1