164976 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: T362008 Page 1 of 1
ONE CIVIC SQUARE REBECCA AMBURGEY UDE
CARMEL, INDIANA 46032 5624 PHEASANT CT CHECK AMOUNT: $100.00
CARMEL IN 46033
CHECK NUMBER: 164976
CHECK DATE: 10/16/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 OTHER EXPENSES
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
xi
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Payee 1
4 bee c,_ tiro ge�l CJIX�� Purchase Order No.
.S$L Terms
La -r� —Z-?J L 403 'j 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
VOUCH ER_ Na._ WARRANT NO.
ALLOWED 20
�ej,r a- /`tnr.brJ:aeU o�e IN SUM OF
Aga 4/-
C7
ON ACCOUNT OF APPROPRIATION FOR
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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund