165186 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 354551 Page 1 of 1
t ONE CIVIC SQUARE CONSECOR ELLIS /COST CNTR 0010006
0 CHECK AMOUNT: $2,700.00
CARMEL, INDIANA 46032 CIO CONSECO ATI'N: TONY KIX
off 11825 N PENN CHECK NUMBER: 165186
CARMEL IN 46032
CHECK DATE: 10/29/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
Sol 5023990 2,700.00 REFUND
i.
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
TO
•k
•a
ADDRESS
Invoice Date Invoice Number Item Amount
r`
1 0167710?
�d /Z9 /dD/
I hereby certify that the attached invoice(s), or 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
Mo. Day Yr. S� n re Title
I hereby certify that the attached invoice(s), or bill(s), is are) 1 ir and rrect and I have audited same in accordance
with IC 5- 11- 10 -1.6.
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
s ACl OUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
NO,
CARMEL, INDIANA
Favo f
p ,�Cvs��'�r oors�ov
d C".re ca n R 70 Y kir
�1PZ Lw IF Al i A-
Total Amount of Voucher
Deductions
Amount of Warrant
Month of Yr
VOUCHER RECORD No.
Source of Suppl
Water Treatment
Transmission and Dist. c
Customer Accounts
Administrative and General
Operation Maintenance
r
Utilit Plant in Service
Constr. Work in Progress
Materials and Supplies
Custo `ers Deposits
Total
Allowed
e
Board of Control
Filed
Official Title
BOYCE FORMS SYSTEMS 1 -800- 382 -8702 325
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