191294 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 355473 Page 1 of 1
0 ONE CIVIC SQUARE DAREN MINDHAM
CARMEL, INDIANA 46032 221 CORRAL COURT CHECK AMOUNT: $15.00
FISHERS IN 46038
CHECK NUMBER: 191254
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4352600 15.00 AUTOMOBILE LEASE
Cardmember Service
October Statement for activity from Sep. 16, 2010 through Oct. 14, 2010 Inquiries: 1- 800 558 -3424
DAREN J MINDHAM Page 2 of 3
Vlsa SetecE
This Year
Statement to Date
Description of Activity
Base Reward Points
For rewards program inquiries and redemption information, call 1- 888 229 -8864 between 8 a.m and 11 p.m. (Central
Time) Monday through Friday and 8 a.m. to 9 p.m. (CT) on Saturdays and Sundays. Automated account information is
available 24 hours a day, 7 days a week.
Transactlrons......:;.
Post Trans Ref.
Date Date Nbr Description of Transaction Amount
Payments and::Other,Gredits.
09/27 09/24 0052 PAY T
MENT HANK YOU
purcltassS arid::Other :Debits
09/16 09/15 1267
10/14 10/13 3909 L2G *IN BMV BRANCH #803 888 692 -6841 IN $15.00
2010 .Totals :Year?to =Date>
Total Fees Charged in 2010 $0.00
Total Interest Charged in 2010 $0.00
The Year -To -Date Fee accumulation shown on your statement for 2010 includes fees assessed beginning on May
24, 2010 through year end. Beginning in 2011, your statement will show all fees assessed on your account annually.
The Year -To -Date Interest accumulation shown on your statement for 2010 may not include interest reversals
processed prior May 24, 2010. Beginning in 2011, your statement will show all net interest assessed on your account
annually.
Continued on Next Page
VOUCHER NO. WARRANT NO.
ALLOWED 20
Daren Mindham
IN SUM OF
c/o One Civic Square I
Carmel, IN 46032
$15.00 1
1
ON ACCOUNT OF APPROPRIATION FOR
1
Carmel DOCS Department j
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1192 43- 526.00 $15.00 1 hereby certify that the attached invoice(s), or
i
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
y
Monday, October 25, 2010
66 irec tor, D&AS
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/25/10 BMV Costs $15.00
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