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HomeMy WebLinkAbout200141 08/03/2011 CITY OF CARMEL, INDIANA VENDOR: 365556 Page 1 of 1 ONE CIVIC SQUARE TIMOTHY VANDERGRIFF CHECK AMOUNT: $69.92 CARMEL, INDIANA 46032 963 E 300 S TIPTON IN 46072 CHECK NUMBER: 200141 CHECK DATE: 8/3/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 9115 69.92 OTHER EXPENSES WGE i-CU 3700 W BETHEL AVE z. MUNCIE, IN 47304 -5409 KE DEMCREW WHOM 4'` VI Iii 911$ MAKE CHECK PAYASLE TO: AffY VAMIERGRIFF WGE FCU TIFiO"f #4Y VANDERGR%FF 314 PO BOX 50424 963 E 300 s INDIANAPOLIS IN 46250-0424 TIPTON IN 46072 -9214 475072aaa Qaa9.115000l(2500000346659 PLEASE DETACH AND ENCLOSE TOP PORTION WITH PAYMENT. Siam �?nt date. 47113/11 AMY VANDERGRIFF t l ow 19115 um RQ�rence A�u�nE�er s arches Faym ►t arssi edjts Su[ce E asi...... narrf Arrsasuit Tral is: <1ast:: t i urtol I U71u3 2429Q_ 1B5l 4SQ T TSZXO ,3GPE:fdNEY STO y780 f fQKOMO IN 74-Si 5 81/5333/050906 SJB BASIC POCKET. TEE en1eA..u�na /sales...�eN QTY 1, 25.00 �1kL 8 ,a,. .eOlJd pe1"unoos la Sale Disc 15- 1iL 8 51 Q��I Cart Incept 1 25 g 'gT- 1 Total mDrsco�nts -P6.28 9z T_ IueOul IJe3 Discounted Price TO tpslo ales Net.Sales /Return Valu6 B. 00`92 T AID 8: ;74T 331 13i130 01svo ecs 906050/£££5/189 iW 8 en ieA ujnlea /sa ieS ION Total Certificate 10.00 bL.B aO1Jd pelunooslp Subtotal 6 191_ sloo?s19 Pol Sales Tax 7,0000 86902 9.92 iueoul I 0 9.89 Oslo eleS Total, 14.81 oo �z 1 A1t7 331 IWOd 3TSV9 8CS 906090/EE£0/I Total Items Sol 8 erilpA uJnlaa %salpS I ON Total Items Returned: 0 1bL 8 BOIJd peluriodslo Y.ou total' Savi Today 100,08 hL 8 T s�oost� lsal VISA �Z 9T ,lu9bu:,I I XXX XXXXXXXXX 9 115 /XXXX/001932005 M 74.81 1 esip TO 9I ;a r ,h10, Cardholder acknowledges receipt of 331 13>f�Od'`3ZSV 8CS 906090/£EC9 89 goods /services in the amount shown aiid p ibL S. 66lek u:injea /sales IeN agrees to ay for them according to credit eolJd pelunooslo contract with card issuer. W9 1 9T, s��moos lQ:, l�a� gZ I;. as ua2ul l ae� 1 i0 ale.$ Story 1 A10,, 07$0 Term 0 Tran: 9129 Date 00 +9Z 07IOlr/11 Tjime 11;;13 AM Assoc; .0115 331 13NOOd 3ISV8r8CS 90L LO /ECCS /k8 �n an loeA uJnl ea %se has Ie kWW1tWWW1�WWWWWW7tWN' WWWW1cW ..?tKWWWWYtxY,WkWWltWWWiCN' J 8 a9},��a��peIUr10�8�0,,. Our best custome'rs to �U© rawarded 9 b�Lt`8 x�� Earn $10 j,cp rewards for shopp'inq e wa rd l y r r w i rkc 9� Go to ,j cprewards. com for more detail,$ uaauI IJe0 9Z�I Oslo ales x'WWWWWINWWWWWWW tWWWWWW W.W W.XW �"k W 1lW 5CW WWW:M iD �1 00"4z 1 h10 JCPenney gladly accepts returns /exchanges 331 137130d 3TSV8 WS 9OLOL0 /£££5 /TR within 90 days of original purchase. en1eA a /seleS ION Return privileges'for. this receipt expire 10L uJn }e '8 001 pelunop5lp on: hL'8 S�UIl0�5la 1 09/29/2011. gay gT- Returns without a receipt Will be refunded Iueoul WOO at the lowest on sale price within the 9Z'1 Oslo ales last 30 days, and be given in the form of 10 AID a JCPenney Merchandise .Return Voucher. No 00 9Z 90LOLO /£££9 /T89 refunds 90 days after or'igfnal purchase 331'".13N3Od 3ISV8 8Cs date, 1W8 enleA uJnlea /sOlaS ION bL eO.lJd pelunoo WWWWWYe k' YCWWx W:CW W *WW;CWWW *)tWWWWWx'YC;F YC 1 kWWWWit lk* k�� S�l�1o�S1Q ��T f M� 77 g W:Y 7t lKW WWW WyrW *WWWW WWWWWW *IC x'WYC JY Tell us about your shopping experience at GZ T_ iueoul IJO3 www j c:-p aom /survey TO.91- Oslo elpS Type directly into the address line. 00-gZ .T AID Do not use web search to access. 331 13N�Od`OISV8'9CS' 906090/£££9/189 Please see back Access Code :0780o092e9129t070111e1113s1 Access code valid for 7 days -7 WWWfY 1 tWWWWWWWWWWYt YCW7t ir WxlYxWICWkW)C :MWWWWI IZ.TT8— L19.;b 3NNOHHd W& WWWWWWWWWWWWWWWWx 'WWWWWWWWWW *W'K 7fWWWWWWW C!069V; NI Ow0yu 080311108 3,' 83LI fM ,n L -08LO A3NNA&C at jCPX M I����III II II IIII ff!!II ff IIII II1III�IIIII�I�(I�III Il�llll�fllllll�ll 07011' 107 800092912900' v til VOUCHER 111849 WARRANT ALLOWED TVANDERGRIFF IN SUM OF TIM VANDERGRIFF 3450 W 131 ST ST Opq CARMEL, IN 46074 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 9115 01- 6200 -03 $69.92 Voucher Total $69.92 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee TVANDERGRIFF TIM VANDERGRIFF Purchase Order No. 3450 W 131ST ST Terms CARMEL, IN 46074 Due Date 7/26/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/26/2011 9115 $69.92 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 7lZ9fil C." Date Officer