181552 01/20/2010 741 CITY OF CARMEL, INDIANA VENDOR: 00351592 Page 1 of 1
ONE CIVIC SQUARE FORD MOTOR COMPANY
i ,l 0 4 CARMEL, INDIANA 46032 PO sox 70548 CHECK AMOUNT: $549.00
CHICAGO IL 60673 CHECK NUMBER: 181552
CHECK DATE: 1/20 /2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4352600 OO1BCV00047 549.00 AUTOMOBILE LEASE
0,4,...„
„2„..2„, c �a
GOVERNOR MAY
OR LEASE VEHICLE PRG INVOICE: 001BCV00047
PLANT ID NO: U1 QHA INVOICE DATE: 2010/01/10
1350 I STREET NW 10TH FLOOR CUSTOMER REF: BATCH
WASHINGTON,DC 20005 PO/ICBA: 073R524
U.S.A.
SOLD TO: CUSTOMER ID NO: BKKMA
REMIT TO: FORD MOTOR COMPANY
P.O. BOX 70548
CITY OF CARMEL CHICAGO, IL 60673
OFFICE OF THE MAYOR
ONE CIVIC SQUARE
CARMEL,IN 46032
U.S.A. BJLLINGCONTACT: ALICIA PATTERSON
PHONE: 615 -315 -6677
THIS-- NVGICE- IS-FOR VE -HICLE /VEHICLES- J
LEASED FOR DECEMBER 2009, SEE LISTING BELOW:
VIN IN SVC OUTSVC MTHLY DAILY DAY
NUMBR DATE DATE RATE RATE SVC AMOUNT
7KJ17070 102806 549.00 18.04 31 549.00
PURCHASE ORDER NO: 073R524
RETURN A COPY OF INVOICE WITH YOUR REMITTANCE
VIN NUMBR VEHICLE IDENTIFICATION NUMBER
IN SVC DATE IN SERVICE DATE
OUTSVC DATE OUT OF SERVICE DATE
MTHLY RATE MONTHLY RATE
DAY SVC DAYS IN SERVICE
TOTAL AMOUNT: 549.00
U.S. DOLLAR
PAGE 1
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
1/19/10 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.
Payee
Ford Motor Co Purchase Order No.
P. 0. Box 70548 Terms
Chicgo IL 60673 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4 /10/10 001bcv00047 Auto lease for Mayor 12/09 549.00
Total 1549 .00
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.
1/19/10
ALLOWED 20
Ford Motor Co IN SUM OF
P. 0. Box 70548
Chicago IL 60673
549.00
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4352600
Auto lease
Board Members
D PT INVOICE NO. ACCT #!TITLE AMOUNT 1 hereby certify that the attached invoice(s), or
001bcv00047 4152600 $549.00 bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
—if 20/0
S
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund