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159197 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: T361216 Page 1 of 1 is 0 ONE CIVIC SQUARE THE ALS ASSOCIATION OF INDIANA CHECK AMOUNT: $100.00 CARMEL, INDIANA 46032 MS SARAH PAYTON 6525 E 82ND STREET SUITE 115 CHECK NUMBER: 159197 INDIANAPOLIS IN 46250 CHECK DATE: 5/14/2008 D EPARTMENT ACCOUNT PO NU MBER INVOICE N UMBER AMO UNT DESCRIPTION 101 5023990 100.00 GAZEBO REFUND Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. /1 Payee r r� e. �5 A c� y� Purchase Order Igo. (p Sots �Z S S f e., S Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) .a "3�o�' Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance r' with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. F w e f}LS ALLOWED 20 IN SUM OF$ z ON ACCOUNT OF APPROPRIATION FOR �a--z R e. FU il Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or D 5023996 0 1 b-0 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 Je Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund