180735 12/30/2009 6 CITY OF CARMEL, INDIANA VENDOR: 363734 Page 1 of 1
o O NE CIVIC SQUARE AMY AYERS
13165 PLAYER CIRCLE CHECK AMOUNT: $150.00
o CARMEL, INDIANA 46032
M ioi t0� CARMEL IN 46033 CHECK NUMBER: 180735
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
'1207 4239040 150.00 TIP
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.
t.
Payee
4 4e5 Purchase Order No.
Terms
0D3ff Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4 /Q 6?)
4;40 9 mot tz 1/63.42
Total 3.
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
7 f..rs IN SUM OF
/SD, CD
ON ACCOUNT OF APPROPRIATION FOR
&50 L
/ao'? 6/-F
Board Members
PO# DEPT. 4 INVOICE NO ACM AMOUNT hereby certify DEPT. 1 hereb certif that the attached invoice(s), or
/20 390 «'0 /56,6D 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
OLc 2 8 20 G
Signature
(AAA
Cost distribution ledger classification if
claim paid motor vehicle highway fund