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191840 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 354829 Page 1 of 1 ONE CIVIC SQUARE JEREMY J SOUTH CHECK AMOUNT: $133.00 CARMEL, INDIANA 46032 5125 CROWN STREET INDIANAPOLIS IN 45208 CHECK NUMBER: 191840 CHECK DATE: 11/10/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4340800 4 133.00 ADULT CONTRACTORS Jeremy South Invo 5125 Crown Street Indianapolis IN. 46208 Invoice No: 4 317 -514 -8469 Date: 01 Nov 2010 claymansouth@gmail.com rockyrippleclayworks. org o. >f Carmel Clay Parks And Rec kids in gobbling clay turkeys m 7.0 $19.0 $133.00 N OV z0fo BY; Indicates non -taxable item Subtotal $133.00 TAX (0.00 $0.00 Total $133.00 Paid $0.00 Purchase Balance Due $133.00 Description U 4 Y1Y0 e P.O. If P r F G.L. 3a. L Bud Una Des�x Purchaser Date U APPS Date Page 7 of 7 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 354829 South, Jeremy Terms 5125 Crown Street Indianapolis, IN 46208 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 1111110 4 clay turkeys 22868 133.00 Total 133.00 1 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 1 Voucher No, Warrant No. 354829 South, Jeremy Allowed 20 5125 Crown Street Indianapolis, IN 46208 In Sum of 133.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1096 -32 4 4340800 133.00 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 4 -Nov 2010 Signature 133.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund