HomeMy WebLinkAbout322136 02/21/18 CITY OF CARMEL, INDIANA VENDOR: 369334
it ONE CIVIC SQUARE TIM COFFEY CHECK AMOUNT: $""`""'17.00"
CARMEL, INDIANA 46032 C/O STREET DEPT CHECK NUMBER: 322136
CHECK DATE: 02/21/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4358300 0 17.00 OTHER FEES & LICENSES
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 369334
TIM COFFEY IN SUM OF$ CITY OF CARMEL
C/O STREET DEPT 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
$17.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
0 43-583.00 $17.00 1 hereby certify that the attached invoice(s),or 2/16/18 0 $17.00
2201 2201 2201 2201
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesday, February 20,2018
Lunn,Amy
Admin Assistant
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
20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Bureau of Motor Vehicles
( CustomerD
Transaction Receipt I IIIIIIII III VIII VIII VIII VIII VIII VIII VIII IIII
State Form 51717 (R/4-16)
Branch: CARMEL STARS(527) Date: 2/1/18 Time: 9:28:53 am EDT
1.2955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 225801228
Visit Customer: TIMOTHY FORREST COFFEY
Transactions
Trans ID (PIN) Trans Tyne Trans Subtype Amount
288532593 Driver- Issue CDL Learner New $17.00
288532679 Customer-Voter Registration New $0.00
Subtotal: $17.00
Sales/Use Tax: $0.00
Credit Applied: $0.00
Total: $17.00
Payment Method CREDIT Amount $ 17.00
Merchant ID 527BMV Card Type VISA Authorization Number. 852345
Terminal ID 2UA5311 FWZ Entry Method S Trans Sequence No 83857660
Batch'No 0 Account Number ************4339
Total Due: $17.06
Amount Paid: $17.00
Change Due: $0.00
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Customer Copy
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