165240 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: T362049 Page 1 of 1
ONE CIVIC SQUARE ADINA GOODIN
CARMEL_, INDIANA 46032 12921 LIMBERLOST DR CHECK AMOUNT: $30.00
CARMELIN 46033 CHECK NUMBER: 165240
CHECK DATE: 10/29/2008
,DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 192688 30.00 REFUNDS AWARDS INDE
e
no
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Goodin, Adina Terms
12921 Limberlost Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/7/08 192688 Refund 30.00
Total 30.00
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
Voucher No. Warrant No.
Goodin, Adina Allowed 20
12921 Limberlost Dr
Carmel, IN 46033
In Sum of
30.00
I
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/rITLE AMOUNT Board Members
Dept
1047 192688 4358400 30.00 1 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
22 -Oct 2008
Signature
30.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund