320882 01/17/18 Cnq,
CITY OF CARMEL, INDIANA VENDOR: 361022
d ONE CIVIC SQUARE LARRY EIDSON CHECK AMOUNT: $***....*35.00*
,4 CARMEL, INDIANA 46032 9010 EAST 500 NORTH CHECK NUMBER: 320882
?M,�roN.Eo. SHERIDAN IN 46069 CHECK DATE: 01/17/18
DEPARTMENTACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 REIMB 35.00 OTHER EXPENSES
VOUCHER NO. 177180 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor # 361022 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
EIDSON,LARRY CITY OF CARMEL
CARMEL WASTEWATER 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
35.00 361022 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR EIDSON, LARRY Terms
Carmel Wasterwater Utility CARMEL WASTEWATER 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
EIDSON, 01-7040-01 $35.00 and received except 1/10/2018 EIDSON, LARRY $35.00
LARRY
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
Bureau of Motor Vehicles
Customer Transaction Receipt
State Form 51717 (R/ 4-16)
Branch: CARMEL STARS(527) Date: 12/27/17 Time: 2:46:42 pm EDT
12955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 224973586
Visit Customer: LARRY L EIDSON JR --
Transactions
Trans ID (PINI Trans Type Trans Subtype Amount
287105161 Driver-Renew CDL License Renew $35.00
Subtotal: $35.00
Sales/Use Tax: $0.00
Credit Applied: 0.00_
Total: $35.00
—Payment-Meth -GRED - - -Amount $ 35:00 --- -- ---
Merchant ID 527BMV Card Type VISA. Authorization Number 09209A
Terminal ID 2UA5311FYD Entry Method S Trans Sequence No 82771636
Batch No 0 Account Number ************7755
Total Due: $35.00
Amount Paid: $35.00
Change Due: $0.00
***IMPr'tle!within
NOTIG-
If you do not receive your credential, registration or 14 days o u have questions regarding the print/mailing status of
your cre re�andcalling
title, please visit www.my com and create or log into your account or call the BMV Contact
Cent at 8 -692 will be able to track the progress of your registration or title by using your Transaction ID PIN
number a ove 888-692-6841. Please allow 30 days to receive an approved Personalized License Plate.
You may renew your motorcycle learners permit only one time;for one year. If you do not obtain a motorcycle endorsement
before the expiration of the renewed motorcycle learner's permit;-you must wait one year to apply for a new permit(IC 9-24-8-3).
Please help us improve our service by completing a one-minute customer satisfaction survey. Your responses are completely
confidential.Visit http://www.in.gov/bmvsurvey/start and enter the survey code 224973586 to get started. Thank you.
www.Facebook.com/inbmv KK www.Twitter.com/inbmv www.myBMV.com
VIII IIIII IIIII IIIII III II IIIII IIIII VIII VIII VIII VIII VIII VIII III Customer Copy
5 1 7 1 7 2 8 7 1 0 5 1 6 1
Page 1 of 1