186467 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 241254 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH CHECK AMOUNT: $16.59
CARMEL, INDIANA 46032 C/O CARMEL POLICE DEPT
'4p C/O CARMEL POLICE DE CHECK NUMBER: 186467
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4358300 16.59 OTHER FEES LICENSES
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PAY TO THE T?AY pNLY THIS AqQ_ NT 'T Y
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URCHASER, SIGNER FOR DRAWER COMPRADOR, RRMA DEL LIBRADOR W
PURCHASER, BY SIGNING YOU AGREE TO THE SERVICE CHARGE AND OTHER TERMS ON THE REVERSE SIDE I f 3 m m
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MONEY ORDER: ADDRESS GIFT CERTIFICATE: RECIPIENT f I 7 f 1
Payable Through ISSUER /DRAWER: O 4_I 1 .L `t C 1 F. ._i
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MONEYGRAM PAYMENT SYSTEMS, INC. O AUTHENTICATE RUB T a o
South Central, N.A.
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Anchorage, Alaska
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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
Petty Cash Purchase Order No.
3 Civic Square Terms
Carmel, IN 46032 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
P etty Cash IN SUM OF
3 civic Square
Carmel, IN 46032
16.59
ON ACCOUNT OF APPROPRIATION FOR
po general fund
Board Members
PO# or DEPT q INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 583 16.59 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
,Tune "3 20 10
Signature
Chief of Police
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund