192142 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 361926 Page 1 of 1
ONE CIVIC SQUARE DOUG KIZER CHECK AMOUNT: $190.97
4�o CARMEL, INDIANA 46032 13504 E 131 ST
FISHERS IN 46037 CHECK NUMBER: 192142
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 190.97 OTHER EXPENSES
(44 tolt
DUPLICATE
THANK YOU FOR CHOOSI G MCDONALDrcoS
75 E R. .j��_3
46032-2806
1 THANK YOU
TEL# 317 846 9776 Store# 3894
KS# 2 Nov.11'10 (Thb) 08:27
MFY SIDE 1 KVS Order 24
QTY ITEM TOTAL
80 EGG MCMUFFIN 175.20
Subfotfl 175.20
Tax 15.77
Take -Out Total 190.97
Cashless 190.97
Change 0.00
MER# 19244902
CARD ISSUER ACCOUNT#
Visa SALE *0600
AUTHORIZATION CODE 07548C SEQ# 102682
MCDONALDS 3894
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Doug Kizer
IN SUM OF
13504 E. 131st Street
Fishers, IN 46037
$190.97
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT# LE AMOUNT Board Members
1120 $190.97 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
NOV 61 2 nnen
7
f Fire Chief
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))
Food for FF's for fire on 11 -11 -10 $190.97
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