HomeMy WebLinkAbout303173 09/15/16 CITY OF CARMEL, INDIANA VENDOR: 369425
j 1 ONE CIVIC SQUARE MATT LAFOLLETTE CHECK AMOUNT: $*******135.00*
i•. i° CARMEL, INDIANA 46032 WASTEWATER PLANT CHECK NUMBER: 303173
CHECK DATE: 09/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 213297561 135.00 OTHER EXPENSES
VOUCHER # 166109 WARRANT# ALLOWED
369425 IN SUM OF $
LAFOLLETTE, MATT
SOUTH PLANT
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
LAFOLLETTE 01-7042-05 100.00
1 -35,00
Voucher Total _,A9'00
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
369425
LAFOLLETTE, MATT Purchase Order No.
SOUTH PLANT Terms
Due Date 9/7/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/7/2016 LAFOLLETTI 100.00
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
' Bureau of Motor Vehicles
p
.'*� j*�. Customer Transaction Receipt
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BMV• State Form 51717 (R / 4-16)
r .
Branch: CARMEL STARS(527) Date: 9/2/16 Time: 9:30:46 am EDT
12955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 213297561
Visit Customer: MATTHEW DAVID LAFOLLETTE
Transactions
Trans ID (PIN) Trans Tyne Trans Subtype Amount
268323383 Driver- Renew License Renew $36.00
268323691 Customer-Voter Registration New $0.00
Subtotal: $36.00
Sales/Use Tax: $0.00
Credit Applied: ($1.00)
Totat $35.00
Payment Method CREDIT Amount $ 35.00
Merchant ID 527BMV Card Type VISA Authorization Number 104462
Terminal ID 2UA5311 FSP Entry Method S Trans Sequence No 65815552
Batch No 0 Account Number ************8051
Total Due: $35.00
Amount Paid: $35.00
Change Due: $0.00
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11111Customer Copy
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NOTES RECEIPT J D TE =,L ✓� _. O. �— "15
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