193498 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 241254 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH CHECK AMOUNT: $10.39
CARMEL, INDIANA 46032 C/O CARMEL POLICE DEPT
a� �o, CIO CARMEL POLICE DE CHECK NUMBER: 193498
CHECK DATE: 1/5/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4358300 123110 10.39 OTHER FEES LICENSES
MONEYGRAM PAYMENT SYSTEMS, INC. DRAWER
P.O. BOX 9476
MINNEAPOLIS, MN 55480
PlEASE READ REVERSE SIDE vivirw.monevoram.com DATE /AMOUNT
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF
3 Civic Square
Carmel, IN 46032
$10.39
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
1110 43- 583.00 $10.39
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 31, 2010
Chief of Police
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))
12/20110 payment for duplicate title $10.39
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