189429 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 364667 Page 1 of 1
I. 0 ONE CIVIC SQUARE MATT MCKIM
CARMEL, INDIANA 46032 501 BEALS ST CHECK AMOUNT: $100.00
CARMEL IN 46032
CHECK NUMBER: 189429
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 GAZEBO REFUND
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
F�
Aj r. Purchase Order No.
Terms
Z
Date Due
Invoice Invoice Description Amount
p 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
r C r IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
e U n v�
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. i hereby certify that the attached invoice(s), or
,SU z3 9U f 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
fi
�20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund