HomeMy WebLinkAbout198243 06/06/2011 \�f CITY OF CARMEL, INDIANA VENDOR: 354229 Page 1 of 1
ONE CIVIC SQUARE R M D /PATTI CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 PO BOX 1167
RICHMOND IN 47375 CHECK NUMBER: 198243
CHECK DATE: 6/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
801 4347500 528137 100.00 GENERAL INSURANCE
Client: Adam C Miller
Policy #601001685 05/18/2011
Ohio Casualty Group
528137 05/18/2011 New business Bonds New business 100.00'
Public Official Blind for. Adam Mi,l e i
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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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
1' Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
00.0/
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.
kbb ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
1
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
r 3137 4-3q,7HBD
1WOb 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
L 2 20
Sig e
C'
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund