184192 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 364055 Page 1 of 1
0 ONE CIVIC SQUARE KEITH BREWSTER CHECK AMOUNT: $30.00
CARMEL, INDIANA 46032 PO BOX 15985
CINCINNATI OH 45215
CHECK NUMBER: 184192
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 USATT 30.00 GENERAL PROGRAM SUPPL
Carmel •Clay
Parks &Recreation CHECK REQUEST
Date: j t I
Check payable to BAR 2 4 2010
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Name: r "C—+.
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Address: 4
Cit Zi W I
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Mail check to payee Return check to requestor
Check Amount V d Date Required Zd 10
Check needed for r t UYI r'%W1 Lj Ln I'
Sp1 O m n �UU
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO w L
Budget account GL# 100 5D 4'2_,�1()'�)
Budget Line Description ct�-,G- Vwn c
Requested by (print): l Lcyhlr�
Requested by (signature):
Approved by (signature of Division Manager): ��.k't 1 fJ' 3 ((I�
on this date
Form revised 1 -21 -08
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Brewster, Keith Terms
P.O. Box 15985
Cincinnati, OH 45215
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/13110 USATT USATT winner 30.00
Total 30.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 6- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
Brewster, Keith Allowed 20
P.O. Box 15985
Cincinnati, OH 45215
In Sum of$
30.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. 4,CCT #/TITLE AMOUNT Board Members
Dept
1096 -50 USATT 4239039 30.00 1 hereby certify that the attached invoice(s), or
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
8 -Apr 2010
Signature
30.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund