185345 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 190775 Page 1 of 1
ONE CIVIC SQUARE MACO PRESS INC
i CHECK AMOUNT: $267.05
CARMEL, INDIANA 46032 Po eox 329
CARMEL IN 46032 CHECK NUMBER: 185345
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4230100 13672 267.05 EMPLOYEE CHANGE FORMS
ac M1 317- 846 -5567
pres
u 877 -234 -9658
Fax: 317- 846 -5754 Invoice Number 1367
vwvw.macopress.com
560 3rd Avenue S.W. Invoice Date, 4/27/2010
P.O. Box 329 Purchase Order D. CORDRAY
Carmel, IN 46082 -0329
a O UNT
750 EMPLOYEE CHANGE FORM REVISED 7/2009 257.05
Sub -Total 257.05
Tax
Shipping 10.00
Invoice Total 267.05
TERMS: ALL INVOICES DUE UPON RECEIPT. FINANCE CHARGE OF 1.5% PER MONTH,
(18% PER ANNUM) WILL BE CHARGED ON OVERDUE BALANCES. Balance Due 267.05
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)'
ACCOUNTS PAYABLE VOUCHER
CITY OF CArRMEL
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.
uij n Payee
t �6 Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
D EP I 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund