192892 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF COCK AMOUNT: $9.66
CARMEL, INDIANA 46032 C/O PAM LISTER
CHECK NUMBER: 192892
CHECK DATE: 12/1512010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239099 6.68 OTHER MISCELLANOUS
1207 4350100 2.98 BUILDING REPAIRS MA
a� T
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))
7
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
r, c� IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
v ULerzs
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
J�C7
:5 9k bill(s) is (are) true and correct and that the
390 95; materials or services itemized thereon for
which charge is made were ordered and
received except
i( 20 /Z7
gli
Si nature
Titl
Cost distribution ledger classification if
claim paid motor vehicle highway fund