HomeMy WebLinkAbout198693 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 355224 Page 1 of 1
ONE CIVIC SQUARE DAWN PATTYN
CARMEL, INDIANA 46032 141 SHERMAN DRIVE CHECK AMOUNT: $18.21
CARMEL IN 46032
CHECK NUMBER: 198693
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 REIMB 18.21 OTHER EXPENSES
There's away"
JUNE 14, 2011 4:27 PM
867 10 1704 03231 003
867 10 1705 03231 003
RFN# 0323 1031 -7058- 1106 -1420
7UP 120Z 12S A 3.64 SALE
COKE 120Z 12S 1A 5.29
ICE MNTN WTR 4111/24 6.49
COKE DT F /P120Z12S 'IA 5.29
ICE MNTN WTR 4W/24 1 2.50 -WAGG
SUBTOTAL 18.21
A =7% SALES TAX 1.00
TOTAL 19.21
19.21
CASH BACK .00
WAG COUPON SAVINGS: 2.50
WAG ADVERTISED SAVINGS: 1.65
YOUR TOTAL SAVINGS: 4.15
II 111111 1111 !II I IIIIIIIIII (IIII IIII II III IIII !I II I IIIit
1215 S Range Line Rd Carmel, IN
STORE (317)571 -1176
OPEN 24 HOURS
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JUNE 14, 2011 4:28 PM
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WALGREENS #3231
SEQ 323103136 PAYMENT FROM PRIMARY
CARD# *
RETAIN THIS RECEIPT FOR YOUR RECORDS
JUNE 14, 2011 4:28 PM
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$18.21
1 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
Dawn Pattyn
IN SUM OF
$18.21
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 I 1 120- 851.00 I $18.21 1 hereby certify that the attached invoice(s), or
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
J UN 2 0 2011
/-�j
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund