182049 02/03/2010 I' °a CITY OF CARMEL, INDIANA VENDOR: 00350363 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH
+i' CHECK AMOUNT: $29.09
3,; i CARMEL, INDIANA 46032 CIO MAYOR'S OFFICE
CIO MAYOR'S OFFICE CHECK NUMBER: 182049
CHECK DATE: 2/3 /2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4231400 29.09 GASOLINE
c4/ W V
WELCOME
TO
CRYSTAL FLASH
1D18578845 -891
CRYSTAL FLASH #67
545 S RANGELINE RD
CARMEL IN
DATE 91/27/19
TIME 1:19 PM
AUTH# .658336
ODOMETER 2349
FUELMAN PLUS
ACCOUNT NUMBER
XXXXXX XXXXX XX1525
PUMP PRODUCT PPG
89 E85 $2.399
GALLONS TOTAL
12.126 $29.99
THANK YOU
HAVE A NICE DAY
Presr.,ribed by state Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
2/1/10 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
Petty cash Mayor Purchase Order No.
One Civic Sq Terms
Carmel IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1./27/10 Receipt Gas for Mayor's vehicle $29.09
t.
Total .$29.09
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. WAR WIT NO.
'1 /1/10
ALLOWED 20
Petty cash Mayor IN SUM OF
One Civic Sci
Carmel IN 46032
29.09
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4231400
Gasoline
Board Members
DE T INVOICE NO. ACCT #/TITLE AMOUNT 1 hereby certify that the attached invoice(s), or
Receipt 4231400 $29.09 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
20
ignat rye e
J
Title
ms
Cost distribution ledger classification if
claim paid motor vehicle highway fund