HomeMy WebLinkAbout260114 06/28/16 fir • CITY OF CARMEL, INDIANA VENDOR: 3590 6
ONE CIVIC SQUAREKAREN BREEDLOVE CHECK AMOUNT: $*******125.00*
CARMEL, INDIANA 46032 520 SUPER STAR CT CHECK NUMBER: 260114
CARMEI w 46032 CHECK DATE: 06/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 060616 125.00 OTHER EXPENSES
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 6/9/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/9/2016 61616 $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
i
I
Cleaning Invoice
Week Date Fee Place
06/16/2016 125.00 Water Dist. Office
Please Remit to:
Michelle Breedloye
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 ta
520 Super Star Ct
Carmel, IN 46032
317-374-1542