HomeMy WebLinkAbout304207 10/13/16 J'% F,\ CITY OF CARMEL, INDIANA VENDOR: 369679
jg ® I ONE CIVIC SQUARE JESUS HERNANDEZ CHECK AMOUNT: $********77.48*
s ?� CARMEL, INDIANA 46032 19077 PRAIRIE CROSSING DR CHECK NUMBER: 304207
+,�,,�TON�� NOBLESVILLE IN 46062 CHECK DATE: 10/13/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 100816 38.74 OTHER EXPENSES
651 5023990 100816 38.74 OTHER EXPENSES
VOUCHER # 163000 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
100816 01-6200-07 38.74
;�1�2�4 Hwy
Cl
Voucher Total 38.74
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 10/11/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/11/201( 100816 38.74
hereby certify that the attached invoice(s), or bill(s) is (are)true and _
;orrectand I have audited same in accordance with IC 5-11-10-1.6
Date Officer
VOUCHER # 166360 WARRANT # ALLOWED
369679 IN SUM OF $
HERNANDEZ, JESUS
Carmel Utilities
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
100816 01-7200-07 38.74
5 �
Voucher Total 38.74
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 10/11/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/11/201( 100816 38.74
1 hereby certify_that the attached_invoice(s)—,—or—hill(s)—is—(are.)—true and. _—---- - --— ------
,orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
QTY ITEM PRICE TOTAL
--- ---- ----- -----
l 1495714 $19.69 $19.59
1561111 KESTRELRID/439/36/10
or/y/noL Price $31.98
Coupon: 5000052325
Coupon: 5000019208
1 1574326 $19.69 $19.69
1664141 MKESTRELRI/028/31/10
Original Price $31.98
Coupon' 5000052325
Coupon: 6000019288
1 1853986 $19.15 $19.15
1655281 SWALLU@FHL/250/36/30
Original Price $39.90
Coupon: 6000849288
1 1663961 $19.15 $19.15
1665281 SWMLLOWFML/028/36/30
Original Price $39.90
Reason: Tran. Tax Exempt
Coupon: 6000019288
Coupon Savings Sovinna 6008052325 $-20.98
Coupon Savings 6000019288 $-19.38
Sub Total $77.48
Tex $0,00
Total $77.18
Debit Card $77.18
Acot# 1559 u8
You Saved: $72.28
**** Tux Exempt ****
Exempt ID: 0031201650
Customer:
SignX. . . . . . . . . . . . . . . . . . . . . . . . ' ' . . . . ' ' ^
Associate Name' Jeremy
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Irregular Merchandise Not Guaranteed
Returns within 60 dw*o with receipt
Void if: Washed, Worn' Altered/Misused
Sorry no price odJuomento
Thank uou for shopping with us.
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Trx 3977 Str 176 03 10/88/16 20:21
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