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HomeMy WebLinkAboutReceipts Form Pr..crlbed by State Board of Accoun18 Boyce Forms Systems, Muncie. In. U RECEIPT CJ DEPARTMENT OF COMMUNITY SER't'fCES ..NBRAL FORM NO. 352 (REV. le87) G/J~~Yo/ N!! 2273 FUND ~ , ~,~~- .....;.:~'("'-_70L_c ,...~ CARMEL IN., /" . 20 '~ RECEIVED FROM Ci,lcr ~~,e:l.,'-k?-~ ,,---_ ~/ /' - ("" r.t:/ -~ THE SUM OF ,._";~;..L.-- ,.JG&-' ""l...,.-, cV G.-);P"Z>-----_~~ '1'0 /") r,'';"") $ /4 ie'. c.,:.- DOLLARS ON ACCOUNT OF , ? -') , r; - -;7 /. / C\ /.. ./ ..,,;;:::;> " /") 7'" I.~ / /( ....;; c.,......- t.. '.-...~ ? t1./ ""'-,1'-'" \0..-' -" (../C~ ~h f !/ 100 ./7 /0' // ( -1.- ~ ,'. / ~~r.~'_'- PAYMENT TYPE a AMOUNT . "',,,, ,c". f ' CASH CHEC.X!/:7(,;;(.;;<:" M.O. ' E.F.T. c.c./a.c OTHER ?,./ C/ S-'"' ") ",C 4" " to" / -'-"'--"''''-~ C......"..."- .",-::_, ~'" ---y-;r ---..;,;..d....- // " L.,_......'" AUTHORIZED SIGI::I.<TURE ) _ _ _______ _. ~._._'-:VU"". VI> .n1;t;01lDtB tJoyCII "Or~lfSf8teDa"~ M~Cle;-1D"""'" . . . "- RECEIPT C J ~EPARTMENT OF COMMUNITY SER~ES ',.' -,',':::..":'-', ",-..' '..NaRAL FORM ."NO.' aSil' tREV~ '1..7) ~ &~ N2 2230 ,FUND CARMEL IN.. K. . "..:J I 2- ~ ~- 20 C/ ;3:5 ,4 ,(~4"7V $ 7t'7J~ /~v-(~;_. ~~d _.__.,-,.._"---'''---~--------''_.---.-DOLLARS 1 100 I /.'3 - t) 2- 1f)i.- ('~ RECEIVED FROM THE SUM OF ON ACCOUNT OF PAYMENT TYPE a AMO:;;LN. T <' J~ / ~ ') '7 CASH C CK' ./ (P C/t, M.O. E.F.T C.C./B.C OTHER /~' ..>1'" ~~ // ~ ~ ( -r<J.:~~~~, \.~,..,.....-?:.~/ _po AUTHORIZ~., SIGNATU~ III ~ :H.:lO ?UI 1-:0 ?~OObb ?l.': I. 2:1 ~b ?quI BSA Design, Inc. CITY OF CARMEL Check Amount: 700.00 136307 Date: 07/31/2002 Invoice # 528002 Date 07/31/2002 Invoice Amount $700.00 Gross Payment $700.00 Discount Net Payment Notes $700.00 Carmel New Surgery Ctr. - 528002 ,,~~ d . 4i>~; ."'. ; 1G'.:i.:''':~' .',{.',;.'V: