184230 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 362339 Page 1 of 1
ONE CIVIC SQUARE CITIZENS MANAGEMENT INC
4 0 CHECK AMOUNT: $2,965.50
CARMEL, INDIANA 46032 Po BOX szo
4;,�. cap HOWELL MI 48844 -0620 CHECK NUMBER: 184230
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
302 5023990 SWC0000385 2,965.50 OTHER EXPENSES
Citizens
Management Inca. p „RI•,Mf rh, f- i Citizens Management inc., I PO Box 620, Howell, MI 48844 -0620 LOSS Fund Invoice
TO:
MS. SHELLY M. LINGELBAUGH
CITY OF CARMEL
ONE CIVIC SQUARE
CARMEL, IN 46032 l
By
DATE: 03/31/2010
LOSS FUND INVOICE
REFERENCE AMOUNTyDUE
SWC0000385,;
INITIAL DEPOSIT $25,000.00
03131/2010 BALANCE $22,034.50
AMOUNT DUE $2,965.50
IF YOU HAVE ANY QUESTIONS REGARDING THIS BILL PLEASE CONTACT US AT. 517 540 -3186
PLEASE NOTE: WE ARE FORBIDDEN BY LAW TO ISSUE CHECKS SHOULD YOUR LOSS FUND BECOME ZERO BALANCE
Prescribed by State Board of Accounis 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
Citizens Management Inc. Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
03/31/10 swc0000385 Loss Fund Invoice
Total $2
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 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NC CA �9 1 WARRANT NO.
ALLOWED 20
Citizen- Mananc?ment Inc. IN SUM OF
PQ Box 620
well MI 48844 -0690
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Z
91je 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
i Signat e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund