194727 02/16/2011 CITY OF CARMEL, INDIANA VENDOR: 241763 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH CHECK AMOUNT: $134.48
CARMEL, INDIANA 46032 C/0 LISA
C LISA CHECK NUMBER: 194727
CHECK DATE: 2/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 134.48 EMPLOYEE PENSIONS B
VOUCHER 107054 WARRANT ALLOWED
241763 IN SUM OF
PETTY CASH ADMIN
C/O LISA
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
021411 01- 7040 -01 $30.00
02141.1 01- 7200 -07 $16.50
021411 01- 7200 -08 $1325
021411 01- 7360 -08 $6.49
021411 01- 7360 -01 $33.24
021411 01- 7750 -01 $35.00
Voucher Total $134.48
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
24'1763
PETTY CASH ADMIN Purchase Order No.
C/O LISA Terms
Due Date 2/712011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/7/2011 021411 $134.48
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
Date Officer