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331932 11/07/18
CITY OF CARMEL, INDIANA VENDOR: 372779 ONE CIVIC SQUARE RICHARD DOERFLER CHECK AMOUNT: $****"1,072.99* =9 ,ate CARMEL, INDIANA 46032 251 CANTERBURY TRAIL CHECK NUMBER: 331932 WINSTON SALEM NC 27104 CHECK DATE: 11/07/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 0581369005 1,072.99 OTHER EXPENSES VOUCHER NO. 183190 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor # 372779 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER DOERFLER, RICHARD CITY OF CARMEL 251 canterbury trail An invoice or bill to be properly itemized must show: kind of service,where performed, Winston Salem, nc 27104 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit,etc. Payee $1,072.99 372779 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR DOERFLER, RICHARD Terms Carmel Water Utility 251 canterbury trail Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), winston Salem, nc 27104 or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 0581369005 01-4611-00 $1,072.99 and received except 10/31/2018 0581369005 $1,072.99 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 classificatiori if claim paid motor vehicle highway fund. 20_ Clerk-Treasurer City of Carmel Utilities �� G� Account Number 0581369005 P.O.Box 109 Carmel, IN 46082-0109 Amount Due Customer Service www.carmelutilities.com (317) 571-2442 ue ©at Mon-Fri 8am-5pm Amount Due After Due Date RICHARD DOERFLER Service Address 251 CANTERBURY TRL 13440 SHAKAMAC DR WINSTON SALEM, NC 27104 FINAL .. Meter Meter Readings • • Number • • PAYMENT RECEIVED, THANK YOU (237.71) 08/21/18 09/20/18 WATER CREDIT (1002.80) STATE TAX CREDIT (70.19) a s LL U ° Retain this portion for your records. -- . ................_..._.........