327711 07/20/18 `%�c�q�� CITY OF CARMEL, INDIANA VENDOR: 355473
® \1 ONE CIVIC SQUARE DAREN MINDHAM CHECK AMOUNT: $*******109.95*
ate; CARMEL, INDIANA 46032 14118 WARBLER
LER AY NORTH CHECK NUMBER: 327711
,Toa CHECK DATE: 07/20/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4356003 109.95 SAFETY ACCESSORIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 355473 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
DAREN MINDHAM IN SUM OF$ CITY OF CARMEL
14118 WARBLER WAY NORTH 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.
CARMEL, IN 46033
Payee
$109.95
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Dept of Community Service 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
Mindham 43-560.03 $109.95 1 hereby certify that the attached invoice(s),or 7/17/18 Mindham Boots 2018 $109.95
1192 101 1192 101
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
Thursday, July 19,2018
Mike Hollibaugh
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Stout's Footwear Est. 1886
13155 N Meridian Street
Carmel, IN 46032
Phone: (317) 848-5432
7/17/2018 04:37 PM 2/13b/10465
460-9697
DAREN MINDHAM
Special Order Pickup by 8b:Hill-Abel, Sarah
AUSTIN GARGOYLE, in GARGOYLE
1016828 11.5 1 109.95
Previous Payments 0.00
Payment 109.95
Subtotal: 109.95
Total: 109.95
6 - MC/VISA/DISC 109.95
Visa #XXXXXXXXXXXX0014
Approval #517183
Items Sold: 1
tax exempt id 0031201550
TYPE: PURCHASE
AMOUNT: $109.95
DATE/TIME: 07/17/2018 04:38:29
CARD TYPE: VISA
CARD #: XXXXXXXXXXXX0014
ENTRY METHOD: SWIPED
APPROVAL: 517183
1
i
BUYER AGREES TO PAY TOTAL AMOUNT ABOVE
ACCORDING TO CARDHOLDER'S AGREEMENT
WITH ISSUER
** CUSTOMER COPY ***
No Refund after 30 days
No Refund on worn, altered, clearance
Manufacturer defects warranted for 1
year
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rransac tion Details
kcconnt - DAREN I MINbHAM - -Eiidincg ih 0O.14
ACCOUNTSUM ,.
Current Balance Pehding Transactions. Available Credit
Last Statement Balance Statement Closing Date
$ 08/15/2818
minimum Payment Payment Due Date
08/10/2008
POSTED O.
State Date 04/20/18
End Date 07/14/18
TRANSACTION DATE POSTDATE DESCRIPTION AMOUNT
.7J177/1TU.UT
G
S SHOD
a S AR9+'IEL.
CARNiEE_I`91S $1;09.95
S