163236 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 00352767 Page 1 of 1
ONE CIVIC SQUARE WILLIAM HOHLT
CARMEL, INDIANA 46032 CIO DOGS CHECK AMOUNT: $79.04
«per tia s C/O DOGS CHECK NUMBER: 163236
CHECK DATE: 9/3/2008
DEPARTMENT ACCOUNT PO NUMBER INVOIC NUMBER AMOUNT DESCRIPTION
1192 4236000 79.04 SMALL TOOLS MINOR E
I
4 Y
Save money. Live better.
WE SELL FOR LESS
MANAGER STEVE DUBBS
317 875 0273
ST# 1518 OP# 00000228 TE# 19 TR# 02588
DUCK TAPE 007535303669
8 AT 1 FOR 2.88 23.04 0
1$T AID KIT 038137008123H
7 AT 1 FOR 8.00 56.00 0
SUBTOTAL 79.04
TOTAL 79.04
CASH TEND 100.00
CHANGE DUE 20.96
8 ITEMS SOLD 15
TC# 4564 0457 3314 4910 2127
I VIII IIII IIIIII IIII) IIII IIIIII I I I I II I I III III III IIII I II II I II VIII IIII
All aou need for back to school.
At our best-in-class Prices.
08/20/08 12:53:36
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
y
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
&T 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.
C ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
W—05
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
Q 20�
Sign e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund