164665 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 361947 Page 1 of 1
ONE CIVIC SQUARE CROP HUNGER WALKICHURCH WORL'A
CARMEL, INDIANA 46032 ATTN. MIKE AINLEY
K AMOUNT: $100.00
1474 CLEARWATER COURT CHECK NUMBER: 164665
CARMEL IN 46032
CHECK DATE; 10/16/2008
DEPAR ACCOUNT PO NUMB INV NU MBER AM OUNT DESCRIPTION
101 5023990 T 100.00 REFUND
a fi
I
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
Grop�vr Payee
<!,h v fiC-A aj n r o- er t C_ e S Purchase Order No.
f 4 7 4 r 0 Terms
42-a- r no e_". 1 03 v
Date Due
Invoice Invoice Description Amount
Date Number (or note attached in voice(s) or bill(s))
/a ze_ c� l fC or�uf!� •er Oft. S zd0 D�
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
,q f fti yY1 r. /Y
ON ACCOUNT OF APPROPRIATION FOR
L) VX
Board Members
Pp# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
IO l 0�39gD 0 0 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