184221 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 354011 Page 1 of 1
ONE CIVIC SQUARE CENTRAL CHRISTIAN CHURCH CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 C/O JIM REED
1242 W. 136TH STREET CHECK NUMBER: 184221
CARMEL IN 46032
CHECK DATE: 4114/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 GAZEBO REFUND
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.
Payee
�j`�- ��r� �t Purchase Order No.
L l,t> 34, ti S-t- Terms
l AV Li4P03 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
k"
Total
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.
2D
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
C:C -al IN SUM OF
lam. 4 Z LJ
lo0
ON ACCOUNT OF APPROPRIATION FOR
Cti ha Iq e y'
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
pf �,z3 Jg4) C-0 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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund