156397 02/11/2008 CITY OF CARMEL, INDIANA VENDOR: T356111 Page 1 of 1
ONE CIVIC SQUARE DONNA ROGULA
CARMEL, INDIANA 46032 14840 WARNER TRAIL CHECK AMOUNT: $7.00
�T >o� WESTFIELD IN 46074 CHECK NUMBER: 156397
CHECK DATE: 2/11/2008
DLPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1041 4358400 7.00 REISSUE CK 124836
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Office of the
Clerk-Treasurer
January 18, 2008
Donna Rogul a
14840 Warner Trail
Westfield, IN 46074
Dear Donna,
On April 1, 2005 the city of Carmel issued check number 124836 to you in
the amount of $7.00. Our records indicate that as of January 1, 2008, the
check has not been cashed. If the check has been lost and you would like a
reissue, please notify us by returning this form by February 1, 2008 to the
address be low. If there is no reply by the date specified, payment on the
check will be voided. Please indicate below if you would like to have the
new check sent to a different address than listed above.
Address change:
If you have any questions, please contact me at (3 i7) 571-2429.
Thank you,
Jean Belcher
Accounts Payable Administrator
ONE CIVIC SQUARE CARMEL, INDIANA 46032 3 17157 1.2414
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
e+
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
oa
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
wD 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
02 I/ 20 U
409 0�9
ture r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund