HomeMy WebLinkAbout195309 03/15/2011 CITY OF CARMEL, INDIANA VENDOR: 357811 Page 1 of 1
ONE CIVIC SQUARE BRYAN MASON
CARMEL, INDIANA 46032 15311 WANDERING WAY CHECK AMOUNT: $1,260.60
NOBLESVILLE IN 46060
CHECK NUMBER: 195309
CHECK DATE: 3/1512011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4128000 1,260.60 REISSUE CK 159476
03/1112011 14:23 3175712660 CFD PAGE 01/01
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Office of the
Clerk- Treasurer
March 8, 2011
BRYAN MASON
15311 WANDERING WAX
NOBL ESVILLE IN 46060
Dear Sir or Madam,
On 511412008, the City of Carmel issued check 159476 to you or your company for
payment of tuition reimbursement in the amount of $1260.60. As of February 28, 2011,
this check was still outstanding. If you would like this check .reissued, please complete
the bottom of this form and return it by mail to the address listed below, or send a PDF
copy of this form to ciheeks(a�cormel.in,g—ov or fax the completed form to 31.7 -571 -2410
by March 31, 2011. After this date, the cheek will be voided and cannot be reissued.
If you have any questions, please contact me directly.
Cindy Sheeks
Finance Manager
t?
317 -571 -2428
esheeks _carmelJn.
*j' *COMPLETE SECTION BE OW A TURN
Name of person completing form:_
Mail the replacement check to: 1 )a c1(Lo— +�4�
w i1Ok� 1� s ti 11
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ONE CIVIC SQUA.R.F CARMEL, NDIANA 46032 317/571 2414
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�
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note ttached invoice(s) or bill(s))
.(D
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.
-Ff ALLOWED 20
L a� M
IN SUM OF
WO
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
r o j, 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
Id-
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund