163029 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 359506 Page 1 of 1
0 ONE CIVIC SQUARE V G M FINANCIAL SERVICES CHECK AMOUNT: $790.71
4 CARMEL, INDIANA 46032 P 0 BOX 78523
MILWAUKEE WI 53278 -0523 CHECK NUMBER: 163029
CHECK DATE: 8120/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1150 4353099 1196385 790.71 OTHER RENTAL LEASES
I
1111 West San Marnan Drive INVOICE
Waterloo, IA 50701
800- 643-4354(phone)
Financial Services 319 833 -4577 (fax)
IY'e'ty more than mono" Invoice No. Invoice Date Page No.
1196385 07/14/2008 1
0000038504 ..........AUTO"MIXED AADC 350 For customer service contact: 800 -643 -4354
111111, IL1111111111911111111111111111111111111111111111931111 Please call customer service with any address
Attn: PAUL BLOCKOMS changes or questions about your invoice.
BROOKSHIRE FIRST MORTGAGE LLC
12120 BROOKSHIRE PARKWAY
CARMEL, IN 46033 -3314
Customer Invoice Due,
Account Number Invoice Date Number Date
4009604 07/14/2008 1196385 5th of Month
Current Past Due Past Due Past Due Total
Contract No. Invoice Description Charges 1 -30,Days 31 -60 Days 61+ Days Due
004- 4009604 -001 KENNY- MULTIPRO1250
Payment Due 7 0.71 790.71 0.00 0.00 1,581.42
Late Charges 79.07 0.00 25.00 104.07
Total $790.71 $869.78 $0.00 $25.00 $1,685.49
I S3, I 1
KFFP I iPP FR PnRTIr)N Fr)R Yr)I IR RFCr)Rn.4
Prescribed by State Board of Accountg, 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee,
6 M Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
i l
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.
ALLOWED 20
IN SUM OF
To ��53
wouLL w 153P,
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Cj(� grj `J3� 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
gt�4j,k- C:tVAA!P
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund