185158 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 361015 Page 1 of 1
0 ONE CIVIC SQUARE RACHEL BOONE CHECK AMOUNT: $12.28
CARMEL, INDIANA 46032 1020 KESSLER BLVD E DR
INDPLS IN 46220 CHECK NUMBER: 185158
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4239011 REIMB 12.28 SPECIAL DEPT SUPPLIES
IM3 COSTLETON ]:N
6110 EAST 86TH STREET
CASTLETO IN 46250
MEMBER 11797347391 9T
E 919415 SKIN 9.49
E 88172 GOLEAN CRNCH 8.69
E 96928 KRAFT SINGLE 9.05
E 181761 K5 A STRIP 9.99
E 26802 CR�MBLD FETA 5.99
E 186096 HERB TURKEY 11.69
COKE ZERO
Key- --rte L
E 114029 JACIZ'S'SACS 4.99
E 3639 TO FRT MINI BIT 7.99 A
�9�S C, S 4.59
J 924 8.99
E 2:0 CHOC �CHON -49
E uQ00:G 4 C�1 2 -00 i
SUBTOTAL 109.22
A 7.0% TAX 1.82
TOTAL i iiE[oL�
VF 111.04
XXXXIXXXXXXX1003 SWIPED
04/24/10 17:33
Se9 000863 App#: 532385
Resp: AA
Tran ID 011428787000
Merchant I[I 99034611
APPROVED PURCHASE
AMOUNT: $111.04
0346 012 0000000810 0387
OUPON'S TENDERED 2.00
TOTAL NUMBER OF ITEMS SOLD 14
CASHIER: ANTHONY R REG# 12
Lf���f�!•t�[�: 17:33 0346 12 0387 810
PLE =ASE C(. N,F- AGF -:1 r;
VOUCHER NO. WARRANT NO.
ALLOWED 20
Rachel Boone
IN SUM OF
clb One Civic Square
Carmel, IN 46032
$12.28
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
1
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1192 42- 390.11 $12.28 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
Monday, May 10, 2010
Director OCS
Title
i
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/24/10 Supplies for office visitors $12.28
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