155317 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360661 Page 1 of 1
ONE CIVIC SQUARE EDWARD GROGAN CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 5155 GUILFORD AVE
'ti u INDIANAPOLIS IN 46205
CHECK NUMBER: 155317
CHECK DATE: 1/1012008
DEPARTMENT ACCOUNT �PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 R43S9003 16225 122207 200.00 ENTERTAINMENT -ARTS DI
E
Invoice
For performing Yuletide music
at the Carmel Arts District on
2,�� 2 2 2
i ain owed the sure of $200.00.
(Two hundred dollars)
Edward Grogan
5155 Guilford Avenue
Indianapolis, Indiana 46205
(317) 283 -3723
egrogan@connerprairie.org
C 0 INDIANA RETAIL TAX EXEMPT PAGE
®II CERTIFICATE NO. 003120155 002 0
1�.� Jl ��1e�!/ Jl PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35- 60000972 f
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
r.
VENDOR SHIP j
TO
1 i t I V I J 1.1 7 i r 1_ i `,1 j _i
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT"
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
I J t
P
4 C bad
t a O
a
g
Send Invoice To:
l r
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED'
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY,FOR
SHIP REPAID. THE AB VE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY r r
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE A
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO.1 2 2 9A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.--- WARRANT
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Pre scriyed 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.
CdW OA d /P'
6 ctiq Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Z Z_ Z_ C) M y 5 ic #6 �4 0o o
Total VD 6�'
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
VQUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
X 155 6u, 42 a( AP.
/ry '16
ON ACCOUNT OF APPROPRIATION FOR
IJI�o Li 3s c�c�3
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
T I hereby certify that the attached invoice(s), or
ZZZA L- l351v 3 �ZbU, 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
Signatu����
NN77
Cost distribution ledger classification if TitIe
claim paid motor vehicle highway fund