156395 02/11/2008 CITY OF CARMEL, INDIANA VENDOR: 355742 Page 1 of 1
ONE CIVIC SQUARE ANN PERK
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CARMEL, INDIANA 46032 13025 PORTSMOUTH DRIVE CHECK AMOUNT: $42.00
CARMEL IN 46032 CHECK NUMBER: 156395
CHECK DATE: 2/11/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1041 4358400 42.00 REISSUE CK 123106
i
oF. CAq
City o army
t TO C o
Office of the
Clerk- Treasurer
January 18, 2008
Ann Perk
13025 Portsmouth Dr
Carmel, IN 46032
Dear Ann,
On January 26, 2005 the city of Carmel issued check number 123106 to you
in the amount of $42.00. Our records indicate that as of January 1, 2008,
the check has not been cashed. If the check has been lost and you would like
a reissue, please notify us by returning this form by February 1, 2008 to the
address below. If there is no reply by the date specified, payment on the
check will be voided. Please indicate below if you would like to have the
new check sent to a different address than listed above.
Address change:
If you have any questions, please contact me at (317) 571 -2429.
Thank you,
Jean Belcher
Accounts Payable Administrator.
ONE CIVIC SQUARE CARMEL, INDIANA 46032 317/571-2414
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.
�Paye e
6 4 o el Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6-05 /2 3,106 02 dv
z
„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
F
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
D 3Z
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
/a bill(s) is (are) true and correct and that the
3%0 materials or services itemized thereon for
which charge is made were ordered and
received except
20
ure
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund