163776 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 00352767 Page 1 of 1
0 ONE CIVIC SQUARE WILLIAM HOHLT CHECK AMOUNT: $23.96
CARMEL, INDIANA 46032 C/O DocS
cio oocs CHECK NUMBER: 163776
CHECK DATE: 9/1712008
DEPARTMENT A CCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
1192 4239012 23.96 SAFETY SUPPLIES
Z 2622
1995 Fj RHNGE 1-1
CARMEL IN
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8?3.9U
Total c23. ?LP
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
�11 4 ALLOWED 20
IN SUM OF$
G o I�GS
ON ACCOUNT OF APPROPRIATION FOR
AOLS
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
x 3 .910 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 2 00
S' n
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund