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319421 12/07/2017-VOIDED r[qq- "`��'�....'_Mc. CITY OF CARMEL, INDIANA VENDOR: 37209,1 6 ONE CIVIC SQUARE JOHN KELSEY CHECK AMOUNT: S********26.34* CARMEL, INDIANA 46032 12130 OLD MERIDIAN ST CHECK NUMBER: 319421 ,,_To .�o• X417 CHECK DATE: 12/07/17 CARMEL IN 46032 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 3461250001 26.34 OTHER EXPENSES VOUCHER NO. 173555 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor# 372091 IN SUM of$ ACCOUNTS PAYABLE VOUCHER KELSEY, JOHN T CITY OF CARMEL 12130 OLD MERIDIAN ST#417 An invoice or bill to be properly itemized must show: kind of'service,where performed, CARMEL, IN 46032 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit, etc. Payee 26.34 372091 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR KELSEY,JOHN T Terms Carmel Water Utility 12130 OLD MERIDIAN ST#417 Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), CARMEL,IN 46032 or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 3461250001 01-4611-00 $26,34 and received except 12/1/2017 3461250001 $26.34 L&4 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_ Clerk-Treasurer -TCarmel Utilities Account Number 3461250001 P.O. Box 109 Carmel, IN 46082-0109 Amount Due Customer Service ®u ®a e www.carmelutilities.com (317) 571-2442 Mon-Fri 8am-5pm Amount Due After Due Date JOHN T KELSEY AddressService 12130 OLD MERIDIAN ST#417 1787 TIMBER HEIGHTS DR CARMEL, IN 46032 FINAL PeriodService Meter Meter Readings Number _. PAYMENT RECEIVED, THANK YOU (52.68) 10/26/17 11/25/17 PREVIOUS BALANCE CREDIT (26.34) zala s 0