184349 04/14/2010 a CITY OF CARMEL, INDIANA VENDOR: 364035 Page 1 of 1
s4,� 0 `il ONE CIVIC SQUARE FANG -KAI JAO CHECK AMOUNT: $250.00
ra CARMEL, INDIANA 46032 304 E CLARK STREET APT 203
CHAMPAIGN IL 61820 CHECK NUMBER: 184349
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 USATT 250.00 GENERAL PROGRAM SUPPL
Carmel. Clay
Parks &Recreation CHECK REQUEST
Date: MAR 2 4 2010
Check payable to BY
Name: G1n�
Address: b
City, State, Zip 1 D �I b
Mail check to payee Return check to requestor
Check Amount L% Date Required (d
Check needed for lS tbx! I ro 4
iron Oc '5ar-',r, Otxr)
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO �l� 4
Budget account GL bfi to
Budget Line Description Cie r it
Requested by (print): M" k,� LEIc
Requested by (signature): fi#
Approved by (signature of Division Manager):
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.
Terms
Jao, Fang -Kai
304 E Clark St., Apt 203
Champaign, IL 61820
Invoice Invoice Description Amount
Number (or note attached invoice(s) or biil(s)) PO
Date 250.00
3113110 USATT USATT winner
Total 250.00
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.
Jao, Fang -Kai Allowed 20
304 E Clark St., Apt 203
Champaign, IL 61820
In Sum of
250.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1096 -50 USATT 4239039 250.00 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
250.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund