HomeMy WebLinkAbout303240 09/22/16 1�,-G4gMf`
CITY OF CARMEL, INDIANA VENDOR: 355473
4� ONE CIVIC SQUARE DAREN MINDHAM CHECK AMOUNT: $*******124.95*
f9 �_� CARMEL, INDIANA 46032 221 CORRAL COURT CHECK NUMBER: 303240
M roN�, FISHERS IN 46038 CHECK DATE: 09/22/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4356003 090916 124.95 SAFETY ACCESSORIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
DAREN MINDHAM ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
221 CORRAL COURT IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
FISHERS, IN 46038 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$124.95 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Dept of Community Service Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
0 43-560.03 $124.95 1 hereby certify that the attached invoice(s),or 9/16/16 0 Boot-Daren Mindham $124.95
1192 101 1192 101
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, September 19,2016
Mike Hollibaugh
Director
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
,20—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Stout's Footwear Est. 1880
NMeridian Street
{amal. IN 46032
Phone: (87) 848-5432
9/9/2016 03:18 PN 2/50/71354
- 4GO-SBB7
DkREN H[N0H H
Regular Sale by 5C:Leo' Clayton
TABGHEE [I 2R0HN. in BROWN
1010125 11.5 i 124.05
Subtotal: 124.95
Total: 124.05
G - MC/V[SA/DlSC 124.95
Visa #XXXXXXXXXXXXO014
Approval 0418881
lbsmu Sold. l
^
STATE ID # 08312O155O....TAX
EXEMPT—CITY OF CARMEL
TYPE: PURCHASE ^
AMOUNT: *124.95
DATE/TIME: O3/09/2816 03:18:01
CARD TYPE: YlSk
CARD #: XX% XXXXXXXX8O14
ENTRY METHOD: MANUAL /
APPROVAL: 418081
BUYER AGREES TO PAY TOTAL AMOUNT ABOVE
ACCORD)NQ TOCARDHOLDER'S AGREEMENT |
WITH lD8(EH /
w* CUSTOMER COPY �*
^ Nu flafund after 30 days /
No Refund on worn, altered, clearance /
Manufacturer defects warranted for
year
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