165394 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF COY%
CARMEL, INDIANA 46032 C/O KEN MILLER CHECK AMOUNT: $178.96
CHECK NUMBER: 165394
CHECK DATE: 10/29/2008
DEPARTMENT ACCOUNT PO NUMB INVO NUMBER AMOUNT DESCRIPTION E
1150 4237000 44.85 REPAIR PARTS t
1150 4238000 29.61 SMALL TOOLS MINOR E
1150 4238900 32.73 OTHER MAINT SUPPLIES
1150 4239040 62.02 FOOD BEVERAGES
j 1150 4350000 9.75 EQUIPMENT REPAIRS M
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
C Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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1 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
IN SUM OF
/78 y
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
O&V 30 3 70 bill(s) is (are) true and correct and that the
D" 30 materials or services itemized thereon for
�r3w5 which charge is made were ordered and
a e.;, lI received except
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Signature
nirpr_tnr of if
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund