328121 07/25/18 +u•Coq*
a:! CITY OF CARMEL, INDIANA VENDOR: 307600 CHECK AMOUNT: $*******600.00*
• ONE CIVIC SQUARE TREASURER OF STATE
CARMEL, INDIANA 46032 INDIANA STATE BUDGET AGENCY CHECK NUMBER: 328121
200 WEST WASHINGTON ROOM CHECK DATE: 07/25/18
INDIANAPOLIS IN 46204
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 300.00 18ISDT-2904
210 4357000 300.00 18ISSDT-2903
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
Vendor# 307600 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
TREASURER OF STATE IN SUM OF$ CITY OF CARMEL
INDIANA STATE BUDGET AGENCY An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
200 WEST WASHINGTON ROOM rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
INDIANAPOLIS, IN 46204
Payee
$600.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police 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
181SSDT-2903 43-570.00 $300.00 1 hereby certify that the attached invoice(s),or 7/19/18 181SSDT-2903 breath test certification-Keinsley $300.00
1110 210 1110 210
181SDT-2904 43-570.00 $300.00 bill(s)is(are)true and correct and that the 7/23/18 181SDT-2904 breath test certification-Kim $300.00
1110 1 1 210 materials or services itemized thereon for 1110 1 210
which charge is made were ordered and
received except
Tuesday,July 24,2018
Jim Barlow
Chief
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
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: 181SDT-2903
Treasurer of State Invoice Date:July 19, 2018
Remit To: Indiana State Budget Agency Vendor: Carmel Police Department
200 West Washington Street Due Date:August 19, 2018
Room 212 Amount Due:$300.00
Indianapolis, IN 46204
FOR YOUR CONVENIENCE WE NOW ACCEPT CREDIT CARDS, PLEASE VISIT:
https://www.payingov.com/indiana/Payment/AccountLookup/1006002242
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: 181SDT-2904
Treasurer of State Invoice Date:July 19, 2018
Remit To: Indiana State Budget Agency Vendor: Carmel Police Department
200 West Washington Street Due Date:August 19, 2018
Room 212 Amount Due:$300.00
Indianapolis, IN 46204
FOR YOUR CONVENIENCE WE NOW ACCEPT CREDIT CARDS, PLEASE VISIT:
https://www.payingov.com/india na/Payment/AccountLookup/1006002242