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166533 12/09/2008 CITY OF CARMEL, INDIANA VENDOR: 359293 Page 1 of 1 ONE CIVIC SQUARE CONTINENTAL AIRLINES CARMEL, INDIANA 46032 ATTN: UATP DEPT CHECK AMOUNT: $1,131.25 PO BOX 0201970 o CHECK NUMBER: 166533 HOUSTON TX 77216 -1970 CHECK DATE: 12/9/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4343004 442.18 TRAVEL PER DIEMS 1120 4343002 183.25 EXTERNAL TRAINING TRA 1192 4343002 252.91 EXTERNAL TRAINING TRA 1202 4343002 252.91 EXTERNAL TRAINING TRA Continental Airlines dQQp ACCOUNT NUMBER: 10050479300000 ACCOUNT STATEMENT CREDIT CARD NUMBER: 00004793000043 CITY OF CARMEL For Statement Period Ending November 30, 2008 CARDHOLDER NAME: INFORMATION SYSTEMS Other Net Issue Departure Routing Fare Airline Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Class Segment Number Credits Rebate Rebate Credits 11/24/08 CHIKE /REBECCA 89081213658452 15879323 $35.00 $0.00 $0.00 $35.00 11/24/08 01/11/09 CHIKE /REBECCA 01275249593962 IND LAX IND KK NWNW 15879323 $219.01 $0.00 ($1.10) $217.91 12/04/2008 Page 1 of 4 Continental Airlines 11 Tnup CREDIT CARD NUMBER: 00004793000068 CARDHOLDER NAME: FIRE DEPARTMENT Other Net Issue Departure Routing Fare Airline Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Class Segment Number Credits Rebate Rebate Credits 11/10/08 VANVOORST /ROBERT 89081375861450 15879323 $70.00 $0.00 $0.00 $70.00 11/10/08 01/18/09 VANVOORST /RMR 332WDB19K IND IVICO RH FLFL 15879323 $298.00 $0.00 ($1.49) $296.51 11/17/08 65715PMT ($327.03) $0.00 $0.00 ($327.03) 12/04/2008 Page 2 of 4 Continental�� Airlines do4P es CREDIT CARD NUMBER: 00004793000084 CARDHOLDER NAME: POLICE DEPARTMENT Other Net Issue Departure Routing Fare Airline Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticker Number Origin To To To To Class Segment Number Credits Rebate Rebate Credits 11110/08 DIXONWICHAEL 89081375861446 15879323 $35.00 $0.00 $0.00 $35.00 11/10/08 12/02/08 DIXON /MICHAEL 00575240132574 IND MEM TUL MEM INI LLLL COCOCOCO 15879323 $187.50 ($1.88) $0.00 $185.62 11118/08 GREEN/TIMOTHY 89081213658404 15879323 $35.00 $0.00 $0.00 $35.00 11/18/08 12/04/08 GREEN/TIMOTHY 01275249593004 IND MEM TUL MEM INI KKKK NWNWNWNW 15879323 $187.50 $0.00 ($0.94) $186.56 12/04/2008 Page 3 of 4 Continental�� Airlines 4Q CREDIT. CARD NUMBER: 00004793000118 CARDHOLDER NAME: DEPT OF COMMUNITY SERVICES Other Net Issue Departure Routing Fare Airline Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Class Segment Number Credits Rebate Rebate Credits 11/24/08 LILLARD /SARAH 89081213658441 15879323 $35.00 $0.00 $0.00 $35.00 11/24/08 01/11/09 LILLARD /SARAH 01275249593951 IND LAX IND KK NWNW 15879323 $219.01 $0.00 ($1.10) $217.91 12/04/2008 Page 4 of 4 Continental�� Airlines 1 dt j es SUMMARY STATEMENT REMITTANCE ADVICE For Statement Period Ending November 30, 2008 ACCOUNT NUMBER: 10050479300000 Previous Balance $327.03 CITY OF CARMEL Payments ($327.03) Charges $1,321.02 Refunds /Adjustments $0.00 PAYMENT OPTIONS CO Rebate ($1.88) OA Rebate ($4.63) Remit Payments by Check To: Continental Airlines New Balance $1,314.51 ATTN: UATP Department P.O.Box 0201970 Date Opened 02/13/2007 Houston, Texas 77216 -1970 YTD Sales $20,725.52 YTD Continental Rebate ($5.38) Wire or ACH Transfer: YTD Other Airline Rebate ($82.15) JP MORGAN CHASE YTD Total Rebate ($87.53) New York, New York 11245 Wire Transfer ABA 021000021 F /C: Continental Airlines, Inc. A/C: 910 -2- 499291 Credit Limit $11,000.00 ATTN: UATP Department 10050479300000 AvailableCredit $9,685.49 Please attach Remittance Advice to Payment For Questions relating to your statement, contact UATP Customer Service at 1- 866 324 -UATP CO nti nentat Airlines STATEMENT SUMMARY For Statement Period Ending November 30, 2008 ACCOUNT NUMBER: 10050479300000 PAYMENT IS DUE IN FULL BY 12/26/2008 CITY OF CARMEL ATTN DIANA L CORDRAY ONE CIVIC SQUARE CARMEL, IN 46032 Previous Refunds/ Continental Other Airline Credit Card Number Cardholder Name Balance Payments Charges Adjustments Rebate Rebate Balance Due 00004793000043 INFORMATION SYSTEMS $0.00 $0.00 $254.01 $0.00 $0.00 ($1.10) $252.91 00004793000068 FIRE DEPARTMENT $327.03 ($327.03) $368.00 $0.00 $0.00 ($1.49) $366.51 00004793000084 POLICE DEPARTMENT $0.00 $0.00 $445.00 $0.00 ($1.88) ($0.94) $442.18 00004793000118 DEPT OF COMMUNITY SERVICES $0.00 $0,00 $254.01 $0.00 $0.00 ($1.10) $252.91 PAYMENT OPTIONS Previous Balance $327.03 Remit Payments by Check To: Payments ($327.03) Continental Airlines Charges $1,321.02 ATTN: UATP Department Refunds /Adjustments $0.00 P.O.Box 0201970 Continental Rebate ($1.88) Houston, Texas 77216 -1970 Other Airline Rebate ($4.63) Wire or ACH Transfer: Balance Due $1,314.51 JP MORGAN CHASE New York, New York 11245 Wire Transfer ABA 021000021 Date Opened 007 0 FlC: Continental Airlines, Inc. YTD Sales $200,,725725.52 A/C: 910 -2- 499291 YTD Continental Rebate ($5.38) ATTN: UATP Department 10050479300000 YTD Other Airlines Rebate ($82.15) YTD Total Rebate ($87.53) Credit Limit $11,000.00 Available Credit $9,685.49 1214/2008 Page 1 of 1 CREDIT CARD NUMBER: 00004793000118 CARDHOLDER NAME: DEPT OF COMMUNITY SERVICES Other Net Issue Departure Routing Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Fare Class Airline Segment Number Credits Rebate Rebate Credits 11/24/2008 LILLARD /SARAH 89081213658441 15879323 $35.00 $0.00 $0.00 $35.00 11/24/2008 01/11/2009 LILLARD /SARAH 01275249593951 IND LAX IND KK NWNW 15879323 $219.01 $0.00 ($1.10) $217.91 12/04/2008 Page 4 of 4 Continental Airfli STATEMENT SUMMARY For Statement Period Ending November 30, 2008 ACCOUNT NUMBER: 10050479300000 PAYMENT IS DUE IN FULL BY 12/2612008 CITY OF CARMEL ATTN DIANA L CORDRAY ONE CIVIC SQUARE CARMEL, IN 46032 Previous Refunds/ Continental Other Airline Credit Card Number Cardholder Name Balance Payments Charges Adjustments Rebate Rebate Balance Due 00004793000043 INFORMATION SYSTEMS $0.00 $0.00 $254.01 $0.00 $0.00 ($1.10) $252.91 00004793000068 FIRE DEPARTMENT $327.03 ($327.03) $368.00 $0.00 $0.00 ($1.49) $366.51 00004793000084 POLICE DEPARTMENT $0.00 $0.00 $445.00 $0.00 ($1.88) ($0.94) $442.18 00004793000118 DEPT OF COMMUNITY SERVICES $0.00 $0.00 $254.01 $0.00 $0.00 ($1.10) $252.91 PAYMENT OPTIONS Previous Balance $327.03 Remit Payments by Check To: Payments ($327.03) Continental Airlines Charges $1,321.02 ATTN: UATP Department Refunds /Adjustments $0.00 P.O.Box 0201970 Continental Rebate ($1.88) Houston, Texas 77216 -1970 Other Airline Rebate ($4.63) Wire or ACH Transfer: Balance Due $1,314.51 JP MORGAN CHASE New York, New York 11245 Wire Transfer ABA 021000021 Date Opened 007 0 F /C: Continental Airlines, Inc. YTD Sales $200,,725726.52 A/C: 910 -2- 499291 YTD Continental Rebate ($5.38) ATTN: UATP Department 10050479300000 YTD Other Airlines Rebate ($82.15) YTD Total Rebate ($87.53) Credit Limit $11,000.00 Available Credit $9,685.49 12/4/2008 Page 1 of 1 CREDIT CARD NUMBER: 00004793000118 CARDHOLDER NAME: DEPT OF COMMUNITY SERVICES Other Net Issue Departure Routing Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Fare Class Airline Segment Number Credits Rebate Rebate Credits 11/24/2008 LILLARD /SARAH 89081213658441 15879323 $35.00 $0.00 $0.00 $35.00 11/24/2008 01/11/2009 LILLARD /SARAH 01275249593951 IND LAX IND KK NWNW 15879323 $219.01 $0.00 ($1.10) $217.91 12/04/2008 Page 4 of 4 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 U n 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. ALLOWED 20 IN SUM OF �so�•ig ON ACCOUNT OF APPROPRIATION FOR C S Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or y3v -v a a S 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 S ture/Z,vC S Cost distribution ledger classification if Title claim paid motor vehicle highway fund Continental Airlines In, SUMMARY STATEMENT REMITTANCE ADVICE For Statement Period Ending November 30, 2008 ACCOUNT NUMBER: 10050479300000 Previous Balance $327.03 CITY OF CARMEL Payments ($327.03) Charges $1,321.02 Refunds /Adjustments $0.00 PAYMENT OPTIONS CO Rebate ($1.88) OA Rebate ($4.63) Remit Payments by Check To: Continental Airlines New Balance $1,314.51 ATTN: UATP Department P.O.Box 0201970 Houston, Texas 77216 -1970 Date Opened 02/1312007 YTD Sales $20,725.52 YTD Continental Rebate ($5.38) Wire or ACH Transfer: YTD Other Airline Rebate ($82.15) JP MORGAN CHASE YTD Total Rebate ($87.53) New York, New York 11245 W re Transfer ABA 021000021 F /C: Continental Airlines, Inc. A/C: 910- 2-499291 Credit Limit $11,000.00 ATTN: UATP Department 10050479300000 AvailableCredit $9,685.49 Please attach Remittance Advice to Payment For Questions relating to your statement, contact UATP Customer Service at 1- 866 324 -UATP CREDIT CARD NUMBER: 00004793000084 CARDHOLDER NAME: POLICE DEPARTMENT Other Net Issue Departure Routing Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Fare Class Airline Segment Number Credits Rebate Rebate Credits 1111012008 DIXON /MICHAEL 89081375861446 15879323 $35.00 $0.00 $0.00 $35.00 11/10/2008 12102/2008 DIXON /MICHAEL 00575240132574 IND MEM TUL MEM IND LLLL COCOCOCO 15879323 $187.50 ($1.88) $0.00 $185.62 11/18/2008 GREEN/TIMOTHY 89081213658404 15879323 $35.00 $0.00 $0.00 $35.00 11/18/2008 12/04/2008 GREEN/TIMOTHY 01275249593004 IND MEM TUL MEM IND KKKK NWNWNWNW 15879323 $187.50 $0.00 ($0.94) $186.56 1� 12!04/2.008 Page 3 of 4 Continental Airlines STATEMENT SUMMARY For Statement Period Ending November 30, 2008 ACCOUNT NUMBER: 10050479300000 PAYMENT IS DUE IN FULL BY 12/26/2008 CITY OF CARMEL ATTN DIANA L CORDRAY ONE CIVIC SQUARE CARMEL, IN 46032 Previous Refunds/ Continental Other Airline Credit Card Number Cardholder Name Balance Payments Charges Adjustments Rebate Rebate Balance Due 00004793000043 INFORMATION SYSTEMS $0.00 $0.00 $254.01 $0.00 $0.00 ($1.10) $252.91 00004793000068 FIRE DEPARTMENT $327.03 ($327.03) $368.00 $0.00 $0.00 ($1.49) $366.51 00004793000084 POLICE DEPARTMENT $0.00 $0.00 $445.00 $0.00 ($1.88) ($0.94) $442.18 00004793000118 DEPT OF COMMUNITY SERVICES $0.00 $0.00 $254.01 $0.00 $0.00 ($1.10) $252.91 PAYMENT OPTIONS Previous Balance $327.03 Remit Payments by Check To: Payments ($327.03) Continental Airlines Charges $1,321.02 ATTN: UATP Department Refunds /Adjustments $0.00 P.O.Box 0201970 Continental Rebate ($1.88) Houston, Texas 77216 -1970 Other Airline Rebate ($4.63) Wire or ACH Transfer: Balance Due $1,314.51 JP MORGAN CHASE New York, New York 11245 Wire Transfer ABA 021000021 Date Opened 02113/2007 FIC: Continental Airlines, Inc. YTD Sales $20,725.52 A/C: 910-2-499291 YTD Continental Rebate ($5.38) ATTN: UATP Department 10050479300000 YTD Other Airlines Rebate ($82.15) YTD Total Rebate ($87.53) Credit Limit $11,000.00 Available Credit $9,685.49 1214/2008 Page 1 of 1 THE TRAVEL AGENT tel 317846.9619 800.347.2512 fax 317848.3998 Fsts�1979 email info@thetravelagent.travel VIRTUOSO MEMBER 11562 Westfield Boulevard I Carmel, Indiana 46032 Web www.thetravelagent.travel ­­­TS IM TX. At? C. r une SALES PERSON: A09DT ITINERARY /INVOICE NO. 51937 DATE: NOV 18 2008 ACCOUNT CPD LSCJFQ PAGE: 01 FOR: GREEN /TIMOTHY P0: CITY OF CARMEL CITY OF CARMEL- POLICE DEPT ONE CIVIC SQUARE 3RD FLOOR ATTN:LUANN THURSTON CARMEL IN 46032 THREE CIVIC SQUARE CARMEL IN 46032 )4 DEC 08 THURSDAY MILES- 381 ELAPSED TIME- 1:30 kIR LV INDIANAPOLIS 1230P NORTHWST AIR FLT:2639 COACH CLASS CONFIRMED AR MEMPHIS 100P NONSTOP RESERVED SEATS 11C AIRLINE CONFIRMATION:NW 4RO38F MILES— 342 ELAPSED TIME— 1:22 kIR LV MEMPHIS 220P NORTHWST AIR FLT :2261 COACH CLASS CONFIRMED AR TULSA 342P. NONSTOP AIRLINE CONFIRMATION:NW 4RO38F SEAT ASSIGNED AT AIRPORT CHECK IN ONLY. )6 DEC 08 SATURDAY MILES- 342 ELAPSED TIME- 1:15 kIR LV TULSA 420P NORTHWST AIR FLT:2262 COACH CLASS CONFIRMED AR MEMPHIS 535P NONSTOP RESERVED SEATS 5C AIRLINE CONFIRMATION:NW 4RO38F MILES- 381 ELAPSED TIME- 1:27 kIR LV MEMPHIS 650P NORTHWST AIR FLT: 175 COACH CLASS CONFIRMED AR INDIANAPOLIS 917P NONSTOP RESERVED SEATS 25B AIRLINE CONFIRMATION:NW 4RO38F CONF NW 4RO38F THIS IS AN ELECTRONIC TICKET. PLEASE PRESENT PHOTO ID AT CHECK IN WITH CONF. TICKET IS NONREFUNDABLE IF UNUSED. MAY.CHANGE ONLY PRIOR TO ORIGINAL TRAVEL DATE. FEES WILL APPLY. *YOU MUST VERIFY ALL INFORMATION IS CORRECT. ONCE ISSUED FEES AND PENALTIES EXIST FOR REISSUES REFUNDS CHANGES. FOR AS YOUR TRAVEL ADVISOR, WE RECOMMEND YOU ALWAYS PURCHASE INSURANCE FOR ALL TRAVEL COMPONENTS. TRAVELEX INSURANCE SERVICES IS OUR PREFERRED PROVIDER_ FOR TERMS AND CONDITIONS, REFER TO: WWW.TT T AV IR RMc THE TRAVEL AGENT tel 317846.9619 800.347.2512 fax 317848.3998 Esubhdhed 1979. email info@thetravelagent.travel V(RT UO S O IVI E M B E R 11562 Westfield BoulevardI Carmel, indiana46032 web www.thetravelagent.travel .1— AU,;,,„ IN. —WT-"� SALES PERSON: A09DT ITINERARY /INVOICE NO. 51937 DATE: NOV 18 2008 FOR: ACCOUNT CPD LSCJFQ PAGE: 02 GREEN /TIMOTHY PO: CITY OF CARMEL CITY OF CARMEL— POLICE DEPT ONE CIVIC SQUARE 3RD FLOOR ATTN:LUANN THURSTON CARMEL IN 46032 THREE CIVIC SQUARE CARMEL IN 46032 AFTER HOURS EMERGENCIES ON EXISTING RESERVATIONS CALL 877 6456373 CODE A09. $15.00 PER CALL FEE WILL BE CHARGED A CANCELLATION FEE OF 10PCT ON TTL COST OF BOOKED TOURS CRUISES LAND HOTEL PKGS WILL APPLY. AIRLINE CHECKED BAGGAGE NOTICE FOR DOMESTIC AND INTERNATIONAL TRAVEL AIRLINES MAY CHARGE THE TRAVEL AGENT THANKS YOU -317 846 9619..DEBBIE WWW.TTA.TRAVEL TICKET NUMBER /S: GREEN /TIMOTHY 7524959300 CARD 187.50 ELECTRONIC AIR TRANSPORTATION 145.12 TAX 42.38 TTL 187.50 PROCESSING FEE 35.00 SUB TOTAL 222.50 CREDIT CARD PAYMENT 222.50 TOTAL AMOUNT 0.00 r AS YOUR TRAVEL ADVISOR, WE RECOMMEND YOU ALWAYS PURCHASE INSURANCE FOR ALL TRAVEL COMPONENTS. TRAVELEX INSURANCE SERVICES 15 OUR PREFERRED PROVIDER_ FOR TERMS AND CONDITIONS, REFER TO: WMYJTA AV I /TERMS Prescriber: by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 7995) 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 Continental Airlines Purchase Order No. ATTN: UATP Department P.O. Box 0201970 Terms Houston, TX 77216 -1970] Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) p ayment for airfare for Assistant Chief Tim Green and 442.18 Lt Mike Dixon while attending the CALEA Conference in a OK on December 1 5 2008 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 C6ntinental Airlines IN SUM OF ATTN: UATP Department P.O. BOx 0201970 Houston, TX 77216 -1970 442.18 ON ACCOUNT OF APPROPRIATION FOR police general fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 1-hereby certify that the attached invoice(s), or 1110 430 -02 442.18 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 December 4 20 08 Signature Chief =of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund Continental Airlines SUMMARY STATEMENT REMITTANCE ADVICE For Statement Period Ending November 30, 2008 ACCOUNT NUMBER: 10050479300000 Previous Balance $327.03 CITY OF CARMEL Payments ($327.03) Charges $1,321.02 Refunds /Adjustments $0.00 PAYMENT OPTIONS CO Rebate ($1.88) OA Rebate ($4.63) Remit Payments by Check To: Continental Airlines New Balance $1,314.51 ATTN. UATP Department P.O.Box 0201970 Date Opened 02/13/2007 Houston, Texas 77216 -1970 YTD Sales $20,725.52 YTD Continental Rebate ($5.38) Wire or ACH Transfer: YTD Other Airline Rebate ($82.15) JP MORGAN CHASE YTD Total Rebate ($87.53) New York, New York 11245 Wire Transfer ABA 021000021 F /C: Continental Airlines, Inc. A/C: 910-2-499291 Credit Limit $11,000.00 ATTN: UATP Department 10050479300000 AvailableCredit $9,685.49 Please attach Remittance Advice to Payment For Questions relating to your statement, contact UATP Customer Service at 1-866- 324 -UATP Continental Airlines 0. ,4 ACCOUNT NUMBER: 10050479300000 ACCOUNT STATEMENT CREDIT CARD NUMBER: 00004793000043 CITY OF CARMEL For Statement Period Ending November 30, 2008 CARDHOLDER NAME: INFORMATION SYSTEMS Other Net Issue Departure Routing Agency Charges/ Continental Airline Charges/ Date Date Passenger Name Ticket Number Origin To To To To Fare Class Airline Segment Number Credits Rebate Rebate Credits 11/24/2008 CHIKEIREBECCA 89081213658452 15879323 $35.00 $0.00 $0.00 $35.00 11/24/2008 01/1112009 CHIKE /REBECCA 01275249593962 IND LAX IND KK NWNW 15879323 $219.01 $0.00 ($1.10) $217.91 12/04/2008 Page 1 .of 4 Prescribed by Slate Board of Accounts City Form No. 201 (Rev. 1995) a 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 Continental Airlines Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) e $217.91 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 8R VOUCHER NO 12/08/ VARRANT NO. ontinental Airlinp ALLOWED 20 Attn: UATP ne IN SUM OF P.O. Box 02019 Ho uston, TX 77216 -1970 $217.91 ON ACCOUf`GLN8fPAL0PUAT&N FOR 1202 Informatin Systems Board Members' PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or 30 002 $217.91 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 Si ture Cost distribution ledger classification if Ti e claim paid motor vehicle highway fund