188740 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 363823 Page 1 of 1
ONE CIVIC SQUARE MATTHEW BROADNAX
CHECK AMOUNT: $10.00
CARMEL, INDIANA 46032
CHECK NUMBER: 188740
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 10.00 REPAIR PARTS
'Ft�1-1-1-10 N A
OPH E 7-
NA
U -f_u CASE
1708 E. 116TH ST.
CARMEL, IN
00000113951 -01 MARATHON AUTO CARE I
1708E 116TH ST CARMEL IN
Descr.
qt y amount
'CUSTOMER COPY>
LABOR
1 10.00 I
Subtotal
T Tax 10 .00
AL 0.00
I
D
10
.00
PAYMENT TIME: 10.00
CARD TYPE EgIT
CARD NA NUMB
ACCT MATTHEW L BROADNAX
EXP.
DATE:
AUTH 090410 TRANS TYPE: SALE
00 DOC 73036
DEBIT AUTH:Interlink
981 566
TffA NKS panied by this bill.
ST# 2088 TILL XX DD AGA I N
CSH: 40 IRAN# hank You
07131110 09:57:42 s
A
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
Matthew L. Broadnax Purchase Order No.
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/31/10 reimburse Officer Matthew Broadnax for tire repair 10.00
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
Matthew L. Broadnax IN SUM OF
10.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 370 10.00 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
August 12 20 10
-&444a
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund