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257848 04/26/16
,y *F CITY OF CARMEL, INDIANA VENDOR: 370216 G ® I ONE CIVIC SQUARE CHRISTINE PAULEY CHECK AMOUNT: $*******754.88* _� CARMEL, INDIANA 46032 87 11TH ST NW CHECK NUMBER: 257848 9M,(IUN�`- CARMEL IN 46032 CHECK DATE: 04/26/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4239099 5159991996 709.88 OTHER MISCELLANOUS 1701 4239002 9346 45.00 REFERENCE MANUALS Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE.VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number ofe'units;price per unit, etc. Pay ( Gum Purchase Order No. lay, l U16 w;e 1'grr> "s � ' YY.'��t../�/ •• •:'4•. •' •late bue • b Invoice Invoice 'Description Amount Date Number (or note attached irivoice(s) or bill(s)) �z q3�6 _ 00 Total ��d • �$ I hereby certify that the attached invoice(s), or bill(s), is (ar ue n c rrect and I ve di d same in accor- dance with IC 5-11-10-1.6. 20 Clerk-Treasur VOUCHER NO. WARRANT NO. ALLOWED /SCJ 20f (6sh(4L& fL1 IN SUM OF $ 75`f• IS $ ON ACCOUNT OF APPROPRIATION FOR 1t,13l ?�.�ll Board Members PO#or INVOICE NO. ACCT#RTE AMOUNT DEPT.# I hereby certify that the attached invoice(s), ne)\ �i5°l`�°��°��� 7°`�•�g or bill(s) is (are) true and correct and that ��o\ °�'��` �tti3`loo �{5•� the materials or services itemized thereon for which charge is made were ordered and received except 20 Sig a ure Title Cost distribution ledger classification if claim paid motor vehicle highway fund FIA CAR® SERVICES"" Fidelity If1VG'St6'tlE'nt5 March 6-April 5, 2016 Page 3 of 4 .B® _® �Ei's'�jf��' ' � r�1w 'TS'4. '•c: .miaa. , .X::r�'rgts^.R',�_"-'_.'c' :hs 1k��-� � k:• 'r' _jkt 'K �Y�t�,p.' Fr`'^YDS,1Y7:;�{'.9{is, ��� Transaction Posting Reference Account Date Date Description Number Number Amount Total Payments and Other Credits 04/01 04/01 PMT FROM BILL PAYER SERVICE 9346 9681 -500.00 -$664.36 03/04 03/07 1.95 03/04 03/07 ( 8.01 03/04 03/07 0.11 03/05 03/07 I 3.92 03/05 03/07 4.60 03/05 03/07 9.00 03/06 03/07 9.74 03/05 03/08 - 3.93 03/06 03/08 2.33 03/07 03/09 2.56 03/08 03/10 03/09 03/12 5.00 03/10 03/12 f: 2.88 03/11 03/14 r . 1.25 03/11 03/14 f 1.01 03/12 03/14 (, ,.. "''.4.51 03/12 .03/14 '. -: 5.83 03/12 03/14 03/12 03/14 -.2 0 03/12 03/15 4.3$ 03/13 03/15 ' 7.93 03/13 .03/15 3.06 03/12 03/16 13.60 03/15 03/16 3.51 03/14 03/17 6.00 03/15 03/17 0.08 03/16 03/18 5.84 03/16 03/18 5.00 03/17 03/19 0 - f _ 0.00 03/18 03/21 GOVERNMf NT'FlNANCE'OFFlCE312-977-9700 IL 13E3 3369 45.00 03/18 03/21 Tnnn WrInn cine Vo1A1A M 44.14 03/19 03/21 18.75 03/20 03/21 =- - 15.97 03/20 03/23 55.00 03/23 03/25 03/23 03/25 „. 28.01 03/23 03/25 46.05 03/24 03/25 29.99 03/24 03/26 �: _. 38.48 03/25 03/28 34.23 03/25 03/28 J4.86 03/26 03/28 54.42 03/26 03/28 _ L8.57 03/26 03/28 _ 48.78 03/26 03/28 21.97 03/27 03/28 9.05 03/25 03/29 r __ 19.07 03/26 03/29 32.66 03/27 03/29 30.03 03/26 03/31 00 rage i or i Sam's Club. Thank you, your order is complete A copy of your receipt has been sent to your email address Items you have already paid for: Order Number:5159991996 Order Date:April 20,2016 Items we're shipping to you Delivery Address: Anne Essex One Civic Square Carmel,IN 46032 ITEMS TO BE SHIPPED SHIPPING METHOD QTY TOTAL i BunnS 12 Cup Digital Dual-Voltage FREE-Standard Shipping 1 $599.00 jt Coffee Brewer Arrives between Apr 26 - Apr 28 Item#:666606 Bunn 64 oz.Lexan Decanter-Black FREE-Standard Shipping 2 $73.92 Handle Arrives between Apr 26 -Apr 28 Item#:656069 Bunn 64-oz Easy Pour Decanter-Orange FREE-Standard Shipping 1 $36.96 Handle Arrives between Apr 26 - Apr 28 Item#:656076 Billing Address: Payment Method: _ Subtotal: $709.88 Christine Pauley AMERICAN EXPRESS:xxxx-xxxx- Shipping: _$0.00 87 11th St NW xxxx-3369 Tax: $49.69 Carmel,IN 46032 Shipped Order Total: $759.57 Have Questions?One of our associates will be happy to help you.Call us at 1-888-746-7726. Site Directory I Privacy Policy I CA Privacy Policy I Terms&Conditions I About Our Ads ©2000-2014,Sam's West, https://www.samselub.com/sams/checkout/orderreceipt/order receipt—Print.jsp 4/20/2016