319435 12/07/17 F1�.�•.C4A,yF!
CITY OF CARMEL, INDIANA VENDOR: 368458
ONE CIVIC SQUARE HANI SOUEIDAN CHECK AMOUNT: $""""27.00•
CARMEL, INDIANA 46032 CARMEL WASTEWATER CHECK NUMBER: 319435
CHECK DATE: 12/07/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 REIMB 27.00 OTHER EXPENSES
VOUCHER NO. 176855 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor# 368458 IN SUM of$ ACCOUNTS PAYABLE VOUCHER
SOUEIDAN, HANI Y CITY OF CARMEL
SOUTH PLANT 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,
numbers of units, price per unit, etc.
Payee
27.00 368458 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR SOUEIDAN, HANI Y Terms
Carmel Wasterwater Utility SOUTH PLANT Due Date
BOARD MEMBERS
I hereby certify that that attached invoice
(s),
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
SOUEIDAN, 01-7200-01 $27.00 and received except 11/28/2017 SOUEIDAN, HANI $27.00
HANI
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
H c,j\j 1
meiier
1424 West Carmel Dr.
Carmel,IN 46032-#130
(317)5738300 meijer.com
The Meijer Team appreciates your business
11/27/17
Your checkout was provided by Fastlane111
MET-IER SAV=NGS
SPECIALS 9.00
SAVINGS TOTAL 9 - 00
YOUR TOTAL SAVINGS
SINCE 01/01/17
1 , 534 . 68
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SALE
GENERAL MERCHANDISE
4282567372 CARHART SOCK
2 0 18.00 36.00 CT
50% off 18.00 -9.00 CT
mPerks # -- :r �rrrrrg7
TOTAL
IN 7% Sales Tax 1.89
TOTAL TAX 1.89
TOTAL 28.89
PAYMENTS
CREDIT CARDS TENDER 28.89
XXXXXXXXXXXX0780 (C)
APPROVAL CODE 023626
Debit
AID AOOOOO00042203
TC DA90589410222FD
NO CVM REQUIRED
NUMBER OF ITEMS 2
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Tx:41 Op:562 Tm:111 St:130 11:02:59
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