195371 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 359341 Page 1 of 1
0 ONE CIVIC SQUARE CASTLETON OUTDOOR SOLUTIONS CHECK AMOUNT: $101.38
CARMEL, INDIANA 46032 7710 JOHNSON ROAD
INDIANAPOLIS IN 46250 CHECK NUMBER: 195371
CHECK DATE: 3116/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350000 REIS CK 1635 101.38 REIS CK 163519
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Office of the
Clerk Treasurer
March 8, 2011 }1
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CASTLETON OUTDOOR SOLUTIONS
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7710 JOHNSON ROAD
INDIANAPOLIS IN 46250
Dear Sir or Madam, J
On 9/4/2008, the City of Carmel issued check 163519 to you or your company for
payment of invoice in the amount of $101.38. 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 csheeks(Da carmel.in.gYov or fax the completed form to 317 571 -2410 by March 31,
2011. After this date, the check will be voided and cannot be reissued.
If you have any questions, please contact me directly.
Cindy Sheeks
Finance Manager
317 -571 -2428
csheeks0),carmel.in. 9v
*COMPLETE SECTION BELOW AND RETURN
Name of completing form: `J c4-�— lJ �•it s a
Mail the replacement check to:
ONE CIVIC SQUARE CARMEL, INDIANA 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
s
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.
J f nc ALLOWED 20
IN SUM OF
0
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
OOOD 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund