164094 09/30/2008 CITY OF CARMEN, INDIANA VENDOR: Page 1 of 1
0 ONE CIVIC SQUARE
CARMEL, INDIANA 46032 CHECK AMOUNT:
CHECK NUMBER: 164094
CHECK DATE:
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB A MOUNT DESCRIPTION
z
z;.
v
REMITTANCE ADVICE tETACH AND RETAIN fqR YOUR RECORDS
Hamilton County Record�r
Jennifer J Hayden
O9/3O/2OO8 11A5:59A Trans OO813841,39
Business Date: 09/30/2008 Rec By: CAR
2088049378 ENCROACHME 11:45!58h
Subtutal: $26.00
20 0 8049379 AMENDMENT 11:45:58A
Subtotal: $28.0U
Receipt Total: $54.UO
Paid By Amount Ref
Check $54.OU 0 0ODOO40 94
CITY OF CARMEL
Rcvd From. CITY OF CAMEL
HAVE A NICE DAY!
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.
I P a yee
{'C��. 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.
4 ALLOWED 20
�c
N SUM OF
CU
ON ACCOUNT OF APPROPRIATION FOR
4oc, 14tt-ac t i,
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
20
Sig
Cost distribution ledger classification if
claim paid motor vehicle highway fund