HomeMy WebLinkAbout193595 01/12/2011 CITY OF CARMEL, INDIANA VENDOR: 357093 Page 1 of 1
ONE CIVIC SQUARE MARCIA WALTON
CARMEL, INDIANA 46032 7434 CARROLL ROAD CHECK AMOUNT: $100.00
INDIANAPOLIS IN 46236
CHECK NUMBER: 193595
CHECK DATE: 111212011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 DEF COMP REFUND
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev, 1995)
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 ��1/lM�� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
VOUCHER NO. WARRANT NO.
,1 ALLOWED 20
(1 IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
aj vukd
b a Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund