190719 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 00353420 Page 1 of 1
ONE CIVIC SQUARE GEORGE W DAVIS CHECK AMOUNT: $17.60
CARMEL, INDIANA 46032 3854 CORNWALLIS LANE
CARMEL IN 46032
CHECK NUMBER: 190719
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4342100 17.60 POSTAGE
,s-
r® ®r
Bight Store. Bight PriC
1217 S. RANGELINE RD.
317 846 -4818
YOUR CASHIER WAS LORI
MR BK OF STAMPS NP 8.80
MR BK OF STAMPS NP 8.80
TAX 0.00
BALANCE 17.60
021 KROGER #959
1217 S. RANGELINE RD.
CARMEL IN 46032
CREDIT CARD Purchase
TOTAL: 17.60
REF 05089A
CREDIT CARD 17.60
CHANGE 0.00
BK OF STAMPS
2 98.80 17.60
TOTAL NUMBER OF. ITEMS SOLD 0
09/29/10 11:04am 959 30 29 504
ENTER TO WIN
ONE OF 20
$100 GIFT CARDS
You are invited to complete a survey
about your recent visit to Kroger
Answer by internet
www.tellkroser.com
You need this receipt to respond,
Survey Entry Code 021 999
THANK YOU FOR SHOPPING KROGER
CUSTOMER SERVICE IS EVERYONE'S JOB.
LET ME KNOW HOW WE ARE DOING.
CHARL BECHEL, MANAGER
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
George W. Davis Purchase Order No.
3854 Cornwallis Lane Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/29/10 reimburse Chaplin George Davis for stamps 17.60
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
G eorge W. Davis IN SUM OF
3854 C6rnwallis Lane
Carmel, IN 46032
17.60
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT f�ITLE AMOUNT
DEPT. I hereby certify that the attached invoices) or
1110 421 17.60 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
October 7 20 10
1
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund