HomeMy WebLinkAbout322540 03/08/18 •r Cqq
CITY OF CARMEL, INDIANA VENDOR: 370141
"< CHECK AMOUNT: $********36.00*
ONE CIVIC SQUARE SAMUEL MOFFITT
CARMEL, INDIANA 46032 300 E 4TH STREET CHECK NUMBER: 322540
v,M, .. SHERIDAN IN 46069 CHECK DATE: 03/08/18
F l>ON4A' .
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4358300 36.00 OTHER FEES & LICENSES
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
Vendor# 370141 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
SAMUEL MOFFITT IN SUM OF$ CITY OF CARMEL
300 E 4TH STREET 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.
ti
SHERIDAN, IN 46069
Payee
$36.00
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
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 $36.00 1 hereby certify that the attached invoice(s),or 3/1/18 0 $36.00
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, March 06, 2018
Huffman, Dave
Director
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
:t * Bureau of Motor Vehicles
=� *k Customer Transaction Receipt I 1111111111111111111 VIII 111111111111111111111111
*BMV State Form 51717 (R/4-16)
r .
Branch: CARMEL STARS(527) Date: 2/28/18 Time: 2:45:08 pm EDT
12955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 226723886
Visit Customer: SAMUEL C MOFFITT
Transactions
Trans ID (PIN) Trans Type Trans Subtype Amount
290033206 Driver-Renew CDL Permit Renew $36.00
Subtotal: $36.00
Sales/Use Tax: $0.00
Credit Applied: $0.00
Total: $36.00
Payment Method CREDIT Amount $ 36.00
Merchant ID 527BMV Card Type VISA Authorization Number 538513
Terminal ID 2UA5311CTW Entry Method K Trans Sequence No 85070028
Batch No 0 Account Number ************2947
Total Due: $36.00
Amount Paid: $36.00
Change Due: $0.00
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