164118 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 354229 Page 1 of 'I
ONE CIVIC SQUARE R M DIPATTI CHECK AMOUNT: $571.00
CARMEL, INDIANA 46032 PO BOX 1167
RICHMOND IN 47375 CHECK NUMBER: 164118
CHECK DATE: 9/3012008
DEPART ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
221 5023990 418490 571.00 BOND
u,.;o.
Client: Carmel Clerk Treasurers Office
Policy #103730101 10/19/2007 10/19/2010
Travelers Property Casualty
418490i 10/19/2008 Installment Crime '.571.00.
L!.!110
U"
PLEASE PAY,�wITHIN'20 'DAYS OF INVOICE DATE OR CALL IMMEDIATELY IF INVOICE IS
571.00
INCORRECT.
********************Future Invoices
Thiok You.
10/19/2009 571.00
M BIAIRM D /PATTI—
e
A.
(317)845 -1547 0 9/19/2008
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
1 CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
Morn, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
1� N6 _P?d Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
91 glow 1 90 LA6-' Li rZ nuU .5
Total 60
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
VOUCI(.ER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
571.
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
Z7 3990 bn 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