193095 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00351592 Page 1 of 1
ONE CIVIC SQUARE FORD MOTOR COMPANY CHECK AMOUNT: $549.00
�la CARMEL, INDIANA 46032 PO BOX 70548
CHICAGO IL 60673 CHECK NUMBER: 193095
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4352600 0123CV00042 549.00 AUTOMOBILE LEASE
i
GOVERNOR /MAYOR LEASE VEHICLE PRG INVOICE: 012BCV00042
PLANT ID NO: UlQHA INVOICE DATE: 2010/12/08
1350 I STREET NW 10TH FLOOR CUSTOMER REF: BATCH
WASHINGTON,DC 20005 POIICBA: 073R524
U.S.A.
SOLD TO: CUSTOMER ID NO: BKKMA
REMIT TO: FORD MOTOR COMPANY
P.O. BOX 70548
CITY OF CARMEL CHICAGO, IL 60673
OFFICE OF THE MAYOR
ONE CIVIC SQUARE
CARMEL,IN 46032
U.S.A. BILLING CONTACT: ALICIA PATTERSON
PHONE: 615 -315 -6677
THIS INVOICE IS FOR VEHICLE /VEHICLES
LEASED FOR NOVEMBER 2010, SEE LISTING BELOW:
VIN IN SVC OUTSVC MTHLY DAILY DAY
NUMBR DATE DATE RATE RATE SVC AMOUNT
7KJ17070 102806 549.00 18.04 30 549.00
PURCHASE ORDER NO: 073R524
RETURN A COPY OF INVOICE WITH YOUR REMITTANCE
VIN NUMBR VEHICLE IDENTIFICATION NUMBER
IN SVC DATE IN SERVICE DATE
OUTSVC DATE OUT OF SERVICE DATE
MTHLY RATE MONTHLY RATE
DAY SVC DAYS IN SERVICE
TOTAL AMOUNT: 549.00
U.S. DOLLAR
PAGE 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ford Motor Company
IN SUM OF
P. O. Box 70548
Chicago, IL 60673
$549.00
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT #i7lTLE AMOUNT Board Members
1160 012BCV00042 43- 526.00 $549.00 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
Friday, December 17, 2010
Ma or
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))
12/08/10 012BCV00042 $549.00
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