312183 06/09/17 a; CITY OF CARMEL, INDIANA VENDOR: 120301
ONE CIVIC SQUARE HAMILTON COUNTY TREASURER CHECK AMOUNT: $*****9,397.80*
=Q; CARMEL, INDIANA 46032 C/O HAMILTON CO AUDITOR CHECK NUMBER: 312183
+y. 1 HAMILTON COUNTY SQUARE CHECK DATE: 06/09/17
NOBLESVILLE IN 46060
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 5/31/17 9,397.80 OTHER EXPENSES
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PRESCRIBED BY STATE BOARD OF ACCOUNTS CITY AND TOWN FORM 217 CT(1997)
REPORT TO COUNTY AUDITOR OF COURT COSTS
COLLECTED IN CITY/TOWN COURT
To the Auditor of Hamilton County, Indiana
I, Christine Pauley, City Officer of the City of Carmel, Indiana, hereby certify that I have received the
following amounts of the court costs payable to the County:
For the month ending MAY 31, 2017.
ITEMIZATION COLLECTIONS PRIOR YEAR TO DATE
THIS PERIOD COLLECTIONS
$9397.80 $46,126.30 $55,524.10
COURT COSTS:
TOTAL AMOUNT COLLECTED $9397.80 $46,126.30 $55,524.10
Dated , 2017
City Fiscal Offi r
NOTE—Mail To:
Hamilton County Auditor
One Hamilton County Square
Noblesville, IN 46060
(Make check payable to Hamilton County Treasurer)
Prescribed by State Board of Accounts
ACCOUNTS PAYABLE VOUCHER C4 Form No.201(Rev.1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee�A6 linc�
`� Purchase Order No.
Rzc�l LAV6 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Tatw
.�
I hereby certify that the attached invoice(s), or bill(s), is (are) ue d orrect and a au ' ed same in accor-
dance with IC 5-11-10-1.6. ^
l9 , 20_n_
Clerk-Treasur