HomeMy WebLinkAbout186455 06/09/2010 a CITY OF CARMEL, INDIANA VENDOR: 364223 Page 1 of 1
ONE CIVIC SQUARE ADAM ORLOWSKI
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CARMEL, INDIANA 46032 14930 MERCURY COURT CHECK AMOUNT: $100.00
CARMEL IN 46032 CHECK NUMBER: 186455
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 OTHER EXPENSES
1
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.
Ca r r+-, Cf l 'f (p 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
1q6: Or c S k i IN SUM OF
�y 3 d e-re- u �y t`-
a -rvY A/ A4Z 0 3 Z
r
ON ACCOUNT OF APPROPRIATION FOR
Lj n(r�L
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
/C� l a.399,L) 'V'10 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
2
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund