HomeMy WebLinkAbout191826 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 00352672 Page 1 of 1
ONE CIVIC SQUARE ADAM SCHRINER
i CHECK AMOUNT: $60.00
CARMEL, INDIANA 46032 cio Docs
Ci0 DOCS CHECK NUMBER: 191826
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4341999 2816699 60.00 OTHER PROFESSIONAL FE
Home MylCC
Shopping Cart j Receipt
Thank you for your order.
Your Confirmation Number Is VrOE6A623239. You May Ella This Page For Your Records.
item quantity price Idiscount Itax Ishipping net -total
Renew 1 Certification 11.00 1 $60.00 Iso.ou I S0.00 1$0,00 1$60.00
B illinqJShipping Information
customer Name: Schriner Adam 3 Blf ling Name: Schriner Adam 3
email: aschriner @carmel.in.gov contact:
phone: (317)571-2435
shipping Label: Mr Adam J Schriner Billing Label: Mr Adam J Schriner
17017 Lakeville Grossing 17017 Lakeville Crossing
Westfield, IN 46074 Westfield, IN 46074
Payment information
Payment Amount: $60.00 Net -Total: $60.00
Payment Method: Visa Net $60.00
Cardholder's Name: Adam 3 Schriner Net Balance: $100
Credit Card Number. 46 *5328
Expiration Date: 2013/09
Authorization code: 356383
Reference Number. VTGE6A523239
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C a Sustainable Attributes Verification and Evaluation Program
One Resource- -Multiple Green Rating Sys #ems
Order Confirmation: Invoice #2816699 Page 1 of 1
Schriner, Adam J
From: CustomerRequest@iccsafe.org
Sent: Sunday, November 07, 2010 8:11 PM
To: Schriner, Adam J
Subject: Order Confirmation: Invoice #2816699
Thank you for your order!
Please save the following invoice information for your records:
Invoice #2816699
Invoice Date: 11107/2010
Shipping Information:
Mr Adam J Schriner 17017 Lakeville Crossing Westfield, IN 46074
Payment Method: Visa
Item Sub -Total Discount Paid Balance
1.00 Renew 1 Certification $60.00 $0.00 $60.00 $0.00
1118/201.0
fOUCHFR NO. WARRANT NO.
ALLOWED 20
J d Schriner
IN SUM OF
,/o One Civic Square
'armel, IN 46032
$60.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
'O# /Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1192 2816699 43- 419.99 $60.00 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
which charge is made were ordered and
received except
Monday, Novem er 08, 2010
1
Director, DdCS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form Flo, 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))
31/07/10 2816699 Renew Certification: Schriner $60.00
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