167433 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 354229 Page 1 of 1
o ONE CIVIC SQUARE R M D /PATTI CHECK AMOUNT: $938.00
CARMEL, INDIANA 46032 PO BOX 1167
i o RICHMOND IN 47375 CHECK NUMBER: 167433
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIPTION
1701 4347500 428379 938.00 GENERAL INSURANCE
H
II
Client: Diana Cordray (B)
e o o
Policy #101002416 01/01/2009 701/01/201.0 1
Travelers Property Casualty
428379 01/01/2009 A i Renew policy Public Official Bond $300,000 938.00:
f
:PLEASE PAY WITHIN.20 DAYS OF INVOICE DATE OR CALL IMMEDIATELY INVOICE IS
INCORRECT. 938.00
Thank You
MBIAIRMDIPATTI
(317)845 -1547 12/17/2008
Prescribed by Stale 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.
Paye
I
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.
&D ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
`,193 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
a�
Signat
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund