187317 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 119835 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY CO -OP INC CHECK AMOUNT: $71.25
CARMEL, INDIANA 46032 PO BOX 1106
NOBLESVILLE IN 46061 CHECK NUMBER: 187317
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 72915 71.25 OTHER EXPENSES
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FARM BUREAU COOPERATIVE O e
ASSOCIATION, INC. o
P.O. Box 1106
16222 Allisonville Road
Noblesville, Indiana 46060 EMERGENCY CONTACT:
CHEMTREC 1- 800-424-9300
SOLD BY CASH CHARGE ON ACCT MDSE. RET TERMS
OTY. DESCRIPTION MIN. comm. UNIT PRICE AMOUNT
17- �U 7( Z�
Aw 1
is
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B y
U L
n SUB TOTAL
SALES TAX ON
Received By
-k-a i Ad itional finance charges may accrue at the rate Of 1 per month (21 oPo APRO)
r' if payment in full is not received by the 301h. Minimum $.50.
FERTILIZER /PETROLEUM GRAIN MERCHANDISING SHERIDAN HORTON ELEVATOR
7,76 -4143 4 773'2685 758 -4181 758 -4463
.;.i -.c fly
VOUCHER 1057 20 WARRANT ALLOWED
L
c. 19835 IN SUM OF
HAMILTON COUNTY CO -OP INC
PO BOX 1106
NOBLESVILLE, IN 46061
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
72915 01- 7202 -05 $71.25
Voucher Total $71.25
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
119835
HAMILTON COUNTY CO -OP INC Purchase Order No.
PO BOX 1106 Terms
NOBLESVILLE, IN 46061 Due Date 6/22/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/22/2010 72915 $71.25
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
7
Date Officer