199011 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 248970 Page 1 of 1
ONE CIVIC SQUARE ANN GALLAGHER
i CHECK AMOUNT: $43.05
CARMEL, INDIANA 46032 171 PARKVIEW COURT
CARMEL IN 46032 CHECK NUMBER: 199011
CHECK DATE: 7/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 43.05 OTHER EXPENSES
#�f; Cf= i`;:31 LETON, IN
6110 EAST 86TH STREET
CASTLETON, IN 46250
MEMBER #1 1 1 777781 31 1
RESALE ON II11
E 85 *DIET COKE* 7.95
E 85 *DIE=TS COKE* 7.95
E 84 *COiA -COLA* 7.95
E 84 *CO(,A;COLA* 7.95
E 10134 *K3 WATERi** 3.75
E 10134 *KS WATER 3.75
E 10134 xxK3 j ATER** 3.75
RESALE TO M 43.05
NON RESALE TOTAL-/ .00
TOTAL k*A
VF EFT' / 43.05
XXXXXXXXXXXX1439 SWIPED
06/23/11 12:53 PIN USED
Se9 000321 Appit: 825618
EFT /DEBIT ResP: AA
Tran ID 117415885000
Merchant ID 99034611
APPROVED PURCHASE
AMOUNT: $43.05
0346 007 0000000044 0029__
CHANGE .00
TOTAL NUMBER OF' ITEMS SOLD 7
CASHIER: JOE S REG# 7
['h•K'r�jojlj 12 :53 0346 07 0029 44
THA11K.' rou r
PL.EASI r',C AGAIN
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 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))
06/23/11 reimburse Ann Gallagher for coke /water $43.05
1 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
Ann Gallagher
IN SUM OF
171 Parkview Court n
Carmel, IN 46032 n
$43.05
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Gift Fund
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
852 852.00 $43.05
I hereby certify that the attached invoice(s), or
I I
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
Tuesday, June 28, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund