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193222 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 354829 Page 1 of 1 0 ONE CIVIC SQUARE JEREMY J SOUTH CHECK AMOUNT: $275.00 CARMEL, INDIANA 46032 5125 CROWN STREET INDIANAPOLIS IN 46208 CHECK NUMBER: 193222 CHECK DATE: 12/22/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4340800 9 275.00 ADULT CONTRACTORS Jeremy South I 5125 Crown Street Indianapolis IN. 46208 Invoice No: 9 317 514 -8469 Date: 21 Nov 2010 claymansouth @gmail.com rockyrippleclayworks.org Carmel Clay Parks And Rec o- adults in pottery 5.0 $55.0 $275.00 Purchase Description iG Y I E( 5 20 1 0 P.O. 2 r P G.L. 9�9c�,SG�o SrG �p Budget Y Line Des V Purchaser Date 7 h, Approv Date Indicates non taxable item Subtotal $275-00 TAX (0.00 $0.00 Total $275.00 Paid $0.00 Balance Due $275.00 Page 1 of 1 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)) Amount 11/21/10 9 Adult clay pottery 22288 68 275.00 Total 275.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 have audited same in accordance with IC 5- 11- 10 -1,6 20, Clerk- Treasurer Voucher No. Warrant No. 354829 South, Jeremy Allowed 20 5125 Crown Street Indianapolis, IN 46208 In Sum of 275.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or Board Members Dept INVOICE NO. ACCT #/TITLE AMOUNT 1096 -50 9 4340800 275.00 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 16 -Dec 2010 Ile Signature 275.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund