167279 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00350524 Page 1 of 1
0 ONE CIVIC SQUARE KENT BROACH CHECK AMOUNT: $75.00
CARMEL, INDIANA 46032 5023 ST CHARLES PLACE
`o CARMEL IN 46033 CHECK NUMBER: 167279
s
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 75.00 TRAVEL PER DIEMS
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.
f Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5
Total
s�
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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE O. ACCT# /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
/G 2 -d 75 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 CS
Si natur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund