HomeMy WebLinkAbout190637 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 364772 Page 1 of 1
Q�
ONE CIVIC SQUARE ASHTON ADAIR CHECK AMOUNT: $100.00
+�r CARMEL, INDIANA 46032 11136 SANABRIA DRIVE
oh `off INDIANAPOLIS IN 46235 CHECK NUMBER: 190637
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 GAZEBO REFUND
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
R e"z' 4L' r Purchase Order No.
e) 0. 1 0 r a Dr Terms
_Z_ n S _T7 A 4 Z 3 S 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
5 7q d-ei- f IN SUM OF
h d I a l s'
ON ACCOUNT OF APPROPRIATION FOR
BEN
C�7GL7.e -bD P
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. !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
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund