HomeMy WebLinkAbout301517 08/04/16 �.4�q
R�%" ""f. - CITY OF CARMEL, IND ANA VENDOR: 369679
® 3, ONE CIVIC SQUARE I JESUS HERNANDEZ CHECK AMOUNT: $***'***160.00'
s9, ,?4 CARMEL, INDIANA 4603 i 19077 PRAIRIE CROSSING DR CHECK NUMBER: 301517
�'�i roei�°' NOBLESVILLE IN 46062 CHECK DATE: 08/04/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 122915 80.00 OTHER EXPENSES
651 . 502399 122915 80.00 OTHER EXPENSES
VOUCHER # 165845 WARRANT # ALLOWED
369679 IN SUM OF $
HERNANDEZ, JESUS
Carmel Utilities
Carmel Wastewater Utility
0 ACCOUNIT OF APPROPRIATION-FO
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
122915 01-7200-07 80.00
�t
Voucher Total 80.00
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
369679
HERNANDEZ, JESUS Purchase Order No.
Carmel Utilities Terms
Due Date 8/2/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/2/2016 122915 80.00
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 # 162250 WARRANT# ALLOWED
369679 IN SUM OF $
HERNANDEZ, JESUS
Carmel Utilities
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
122915 01-6200-07 80.00
5 �
Voucher Total 80.00
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
369679
HERNANDEZ, JESUS Purchase Order No.
Carmel Utilities Terms
Due Date 8/2/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/2/2016 122915 80.00
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
VON MAUR .
Castleton Square Mall
602.0 East 82nd Street
Indianapolis, IN 96250
Tel: (317) 599-1870
Store: 16 Date : 12/29/2015
Res 009 Time 08:18 PM
Trans. 7539 Assoc: 667832
SALE
MENS SHOES 160.00
3275 8 CHOC
588.737872904598 T:0065
Subtotal 160.00
SALES TAX 160.00 11 .20
TOTAL 171.20
SON MAUR CHARGE 171.20
ACCT 4 /S XXXXX9901
AUTH: 999999
NAME:: JESUS HERNANDEZ
Total Ttems Purchased: 1
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s��� CUSTOMER COPY
(l(tT �Y Tp• ACCOUNT NUMBER NEW BALANCE MINIMUM PAYMENT
6565 BRqq D3Y STRF�T,DAVENPORT,IOWA 52806-2054 17994401 402.07 $5.00
1-�!3-388-2240/1-800-458-0396
CHECK HERE IF ADDRESS CHANGES OR PAYMENT IS DUE BY 02/13/2016 AMOUNT ENCLOSED
COMMENTS ON BACK
017994401000850000402078 VON MAUR
JESUS HERNANDEZ PO BOX 790298
19077 PRAIRIE CROSSING D ST LOUIS MO
NOBLESVILLE IN 63179-0298
46062
PLEASE INCLUDE THIS RECEIPT WITH YOUR CHECK TO INSURE PROPER CREDIT TgO�YO�-URACCOUNT.
VON M SVR
DATE DESCRIPTION CHARGES AND PAYMENTS
CREDITS
01/09/2016 RETURN,GIRLS 6X 6.42-
01/16/2016 PAYMENT-THANK YOU 45.00-
12/12-1120,15—
5.00-
12/ 12 1 WOMENS COMFO . � `
_: ��. �...�.,�_ 90.95
12/29/2015
M=Fil
E=NS SHOE=S 171.20
GO GREEN! GNU OR E-STATEMENTS AT WWW.VONMAUR.CO
ACCOUNT PREVIOUS PAYMENTS CHARGES AND NEW BALANCE MONTHLY PAYMENT
NUMBER BALANCE CREDITS PAYMENTS DUE
17994401 191.34 I 45.00- 255.73 402.07 85.00 85.00
TRANSACTIONS AFTER 01/16%2016 WILL APPEAR ON YOUR NEXT STATEMENT. TOTAL DUE
SEE IMPORTANT TERMS ON NEXT PAGE 85.00
RE
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