319422 12/07/2017 C,q
CITY OF CARMEL, INDIANA VENDOR: 372040,,
d ONE CIVIC SQUARE KATHRYN KLEIN CHECK AMOUNT: $ .....120.52'
x � CARMEL, INDIANA 46032 14916 BRIARPATCH CIRCLE CHECK NUMBER: 319422
9M�TON�o` CARMEL IN 46033 CHECK DATE: 12/07/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 0101703815 120.52 OTHER EXPENSES
VOUCHER NO. 173556 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor # 372040 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
KLEIN, KATHRYN CITY OF CARMEL
14916 BRIARPATCH CIR An invoice or bill to be properly itemized must show: kind of service,where performed,
CARMEL, IN 46033 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
120.52 372040 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR KLEIN, KATHRYN Terms
Carmel Water Utility 14916 BRIARPATCH CIR Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), CARMEL, IN 46033
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
0101703815 01-4611-00 $120.52 and received except 12/1/2017 0101703815 $120.52
Ill
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
city 2 ,Vb "I,
�TCarmel Utilities Account Number
0101703815
P.O. Box 109 Carmel, IN 46082-0109
Amount Due
Customer Service
www.carmelutilities.com (317) 571-2442 ®ueADate -;.
Mon-Fri 8am-5pm Amount Due
After Due Date
KATHRYN KLEIN Service Address
14916 BRIARPATCH CIR 14558 CHERRY RIDGE RD
CARMEL, IN 46033
FINAL
PeriodService Meter Meter
Number
PAYMENT RECEIVED, THANK YOU (120.52)
10/26/17 11/25/17
PREVIOUS BALANCE CREDIT (120.52)
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