180724 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 363094 Page 1 of 1
o` ONE CIVIC SQUARE ANITA AHERN
k
k CARMEL, INDIANA 46032 CIO SROOKSHIRE GOLF CLUB CHECK AMOUNT: $278.13
3,, CHECK NUMBER: 180724
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 278.13 TIPS
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
4/ Paye
i J 1 /I< I Purchase Order No.
SNAct-m) Terms
6 400 4 r yo0 Date Due
Invoice Invoice Description Amount
/2/ Date Number (or note attached invoice(s) or bill(s))
40; Dg r /03 if
Total A s
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
,/J
IN SUM OF$
A -/.Q, GJ Lr44E:5 cie a
;1,eivi, q
/g
ON ACCOUNT OF APPROPRIATION FOR
6
1 0 6. ?4 gufes
Board Members
Po# or INVOICE NO. ACCT #,TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
J96 510 4i bill(s) is (are) true and correct and that the
3q6 -4f 6 /6'; q materials or services itemized thereon for
which charge is made were ordered and
received except
20 (7
Signature 7 L 56 144-1-
t.
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund