164084 09/23/2008 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF C OCK AMOUNT: $180.00
C/O KEN MILLER
CARMEL, INDIANA 46032
CHECK NUMBER: 164084
CHECK DATE: 9123/2008
DEPARTM ACCOUNT PO NUMBER INVOICE NUMB AMOUN DESCRI
1150 4355300 180.00 ORGANIZATION MEMBER
I
I
901081 (5/07)
Great Rates! Low Payments! Payments! n t s! s!
FIFTH THIRD BANK Open a Fifth Third Equity Flexline Today.
THIS IS YOUR RECEIPT
WHEN MAKING A DEPOSIT AT A TELLERS WINDOW, ALWAYS OBTAIN AN OFFICIAL RECEIPT.
c Checks and other items received for deposit are subject to the provisions of
the Uniform Commercial Code or any applicable collection agreement.
T1r #1 BC #0295 REH251001442
Cashiers Ck $180.00
9/17/2008 4:13:45 PM
Member FDIC Q Equal Housing Lender.
DEPOSITS MAY NOT BE AVAILABLE FOR IMMEDIATE WITHDRAWAL. BANK SYMBOL, TRANSACTION NUMBER AND AMOUNT OF DEPOSIT ARE SHOWN ABOVE.
Save this Copy 13867723
for your records. FIFTH THIRD BANK
CASHIER'S CHECK Customer Receipt September 17, 2008
Pay to the
Order of: Indiana Alcohal Tobacco Commission 80.00
Amount: ONE HUNDRED EIGHTY 00/100 US DOLLARS
Memo: Permits
Purchased by: City of Carmel /Brookshire Golf
Transaction 402378373 NON NEGOTIABLE
Cost Center: 0296
Method of Purchase: Cash /Check
The purchase of a Surety Bond may be required before any Cashier's Check on this
bank will be replaced or refunded in the event it is lost, misplaced, or stolen.
&5CURE
-Al
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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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee 1
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (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
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
/S U 5'53 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
Signatur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund