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185479 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 360212 Page 1 of 1 s ONE CIVIC SQUARE MATT WORTHLEY CHECK AMOUNT: $11.69 CARMEL, INDIANA 46032 14383 GEORGE COURT CARMEL IN 46032 CHECK NUMBER: 185479 CHECK DATE: 5/1112010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4239099 042310 11.69 DUPLICATE KEYS 'k- 7 W; WHITE'S AGE HARDWARE 731 S. RANGELINE RD .1 CARMEL, IN. KEY SINGLE CUT 11.69 7 1.670 SUBTOTAL 11.69 TAXO1 TOTAL 12.51 CASH 20.00 CHANGE 7.49 THANK-YOU! PAD 04/23/10 12:55GN @35881471 21 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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. 5 7 11 :tb .S� Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7 kc s M e 11. 1 Total I 1 (7 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 57 COO 1 40 2 e b ON ACCOUNT OF APPROPRIATION FOR 902 42 -:3 3 0 99 Board Members Pots or INVOICE NO. ACCT #/TITLE AMOUNT DEPT_ I hereby certify that the attached invoice(s), or QZ 04 2:3)0 4239099 11.69 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 10 ignature pirector of Redevelopment Cost distribution ledger classification if Title claim paid motor vehicle highway fund