163777 09/17/2008 a CITY OF CARMEL, INDIANA VENDOR: 00350295 Page 1 of 1
ONE CIVIC SQUARE HOLIDAY INN EXPRESS
I CARMEL, INDIANA 46032 941 INTERSTATE DRIVE CHECK AMOUNT: $497.28
FINDLAY OH 45840
CHECK NUMBER: 163777
CHECK DATE: 9/17/2008
DE PARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 497.28 OTHER EXPENSES
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DATF,: SEPTENMER 8, 2008
STATEMENT [1001
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111 Accounts Payable Invoice/ Rooms
JX Carmel Wastewater Utilities
760 Third Avenue S.W. Suite 110
C=nel, Indiana 46032
Customer IDjeff Cooper
!p
10/20/08 1 Eric Robinson/ 2 day stay
$82,88(2) $165.76
10/20/08 Gregg Epp/ 2 dny stay $82-88(2) S165, 7 6
I
10/20/08
Mcgh Beck/ 2 day stay $82.88(2) $165.76
TOTAL DUE
il-000 I t I +I� 'rl l lil l l I 1 Wt r �1' V �4 A Aft�i�
$497.28
$497.
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Make all checks payable to Holiday Inn Express Findlay
Thank you for your business!
EQ/ZO 39V6 AVC[I t/-Z.1eZVGTV 6Z:CT 800Z/80/60
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T9953
HOLIDAY INN EXPRESS Purchase Order No.
941 INTERSTATE DR Terms
FINDLAY, OH 45840 Due Date 9/8/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/8/2008 100 $497.28
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
'r
Date Officer
VOUCHER 086214 WARRANT ALLOWED
T9953 IN SUM OF
HOLIDAY INN EXPRESS
941 INTERSTATE DR
FINDLAY, OH 45840
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
100 01- 7040 -01 $331.52
100 01- 7042 -06 $165.76
P
Voucher Total $497.28
Cost distribution ledger classification if
claim paid under vehicle highway fund