166840 12/10/2008 i
CITY OF CARMEL INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF COBS
CARMEL, INDIANA 46032 C/O KEN MILLER CHECK AMOUNT: $35.31
CHECK NUMBER: 166840
CHECK DATE: 12/10/2008
DEPARTMENT A CCOUNT PO NUM BER INVOICE NUMBER AMOUNT DESC
`1150 4239040 35.31 FOOD BEVERAGES
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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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number /gyp (or note attached invoice(s) or bill(s))
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
!1 IN 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
Avv'/1 yi ,08 qV T f,�� bill(s) is (are) true and correct and that the
�3 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Cost distribution ledger classification if
Title Director of Golf
claim paid motor vehicle highway fund