HomeMy WebLinkAbout162797 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 279200 Page 1 of 1
ONE CIVIC SQUARE INDIANA SECRETARY OF STATE
CARMEL, INDIANA 46032
NOTARY DEPARTMENT CHECK AMOUNT: $5.00
ROOM 201, STATE HOUSE CHECK NUMBER: 162797
INDIANAPOLIS IN 46204
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
-192 4347500 5.00 GENERAL INSURANCE
r
.,.cnbed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995
a
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
Sh Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
r
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
Inn
Y TI +mc IN SUM OF
r
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 except
20
e l
g ature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund