186582 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 364244 Page 1 of 1
ONE CIVIC SQUARE JANET WADE
14107 WELFORD WAY CHECK AMOUNT: $2,217.00
CARMEL, INDIANA 46032
CARMEL IN 46032 CHECK NUMBER: 186582
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 2,217.00 REFUND
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
TO
n P� Ala 9A
Z �r� r�1
ADDRESS 1 ia
Invoice D f Item Amount
0
i.V !�2Q
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
Mo. Day Yr. Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (1;U ct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
Mo. Day Yr, er Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT.- aNO
NO.
CARMEL, INDIANA
Favor Of
t Rio
e
Total Amount of Voucher $.2. d
Deductions
Amount of Warrant 2.
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist
Customer Accounts
Administrative and General
Operation Maintenance
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
I
Board of Control
Filed
Official Title
BOYCE FORMS SYSTEMS 1 -800- 382 -8702 325