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191310 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 358229 Page 1 of 1 ONE CIVIC SQUARE NICOLE PASSINEAU CARMEL, INDIANA 46032 C/O DOCs CHECK AMOUNT: $80.74 CHECK NUMBER: 191310 CHECK DATE: 10127/2010 DEPARTMENT ACCOUNT PO NUMBER INVOI NU AMO DESCRIPTION 1192 4356001 80.74 UNIFORMS V FTHACTOR SUwrKI 2375 EAST PLEASANT ST., HT. 37 WO8ELSVILLE, IN 16060 317-776-1883 T/cke/. 66740 Date: 70/|i/l0 Time: 5:26 PM x|ore: 611 Resister: 2 Cashi 00117888 Customer: N}CxOL[ pAS5INE8U Phone 37764631|9 It em-------- Amount x001 LTHR LOS 8.5M TL67 7310833 1 80,71 80.74 xvhto+nl C Tox /n+ai «0������� XKXXXXxXXkxXS%��' Uook R^fe,e^ce ¢:000021829202 7\L/' 0.00 l ayr,e to po» the uhvv^ omuvn| according to my curd ^usver oy/'eeneot. Coll 800-968-0734 within 7 dmym to cnnplei= m survey and be entered In m monthly drawing for w chance to win a $3500 shopping spree. (Awarded as Gift Card) Endo 9/30/3011 For complete 6ato/lw or to pmrticipwfo without Purchase or murvey, so to Truc!orSupplu.com/cuafomorwurvoy Enter Store 0: 0624 Enter Reference 4: 0365740 SOLD ITEM COUNT l �N�|N||U UU A�|U QN|NU0 Tl»1y16��� ��AJQKp Please call 877-872-7721 for Customer Service. 5 /e11 vp now for ada, news, and more at Tructvr3upp)y.co" Cvu+onmr Copy VOUCt,,dER NO. WARRANT N Nichole Passineau ALLOWED 20 I IN SUM OF c/o One Civic Square Carmel, IN 46032 I $80.74 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1192 43 -560,01 $80.74 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for r' Which charge is made were ordered and received except i Friday, October 22, 2010 irector OCs Title L; 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 r 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)) 10/14/10 Boots Nichole Passineau $80.74 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 1 20 Clerk- Treasurer