165917 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 354351 Page 1 of 1
ONE CIVIC SQUARE ELIZABETH PICKETT
CHECK AMOUNT: $12.92
CARMEL, INDIANA 46032 1128 ALBEMARLE CIRLCE
NOBLESVILLE IN 46062 CHECK NUMBER: 165917
V CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 4462838 12.92 STORM WATER PHASE II
I
s
ro ®r
Right store. Right price. C v w s
1277 S. RANGELINE RD. Dom( Lx-
317 896 -9818
YOUR CASHIER WAS CHASE
GRN TBLCOVER PC 1.99 T
SC 7192 PLUS CARD SAVINGS 0.90
GRN TBLCOVER PC 1.99 T LA3 SV1� wCtO 4't
SC-7192 PLUS_ CARD SAVINGS 0.90
KRO COCOA PC 1.60 F is 1 errot'h,
SC 5276 PLUS CARD SAVINGS 0.2.8
EDL BRUSH 2,49 ,T
1 5/1.00
STRAW 0.2C
1 5/1.00
STRAW 0.20
1 5/1:00
STRAW 0.20
1 00
K A UNSWTND 0.20
1 5/1 4
K A UNSWTND 0.20
1 5 /i.00
K A UNSWTND 0,20
1 5 /1.00
K A UNSWTND 0.20 F
1 5/1.00
K A UNSWTND 0.20 F
1 5 /1.00
K A UNSWTND 0.20 F
i 5 /1.00
STRAW 0,20 F
1 5/1.00
CHERRY 0.20 F
1 5 /1.00
STRAW 0.20 F
1 5/1 .00
STRAW 0.20 F
1 5/d 00
1 STRAW 0.20 F
5/1.00
K A UNSWTNO 0.20 F
1 5/1.00
1
STRAW
5 /1 0.20 F
CHERRY 0.20 F
1.@ 5/1.00+
K UNSWTND "0.20 F;
1 5/1.00
.K A UNSWTND Z.
K A UNSWTND 0.20 F
KRO WATER 0.85 F j
KROGER PLUS CUSTOMER
TAX *a* *0284 TAX EXEMPTION 0.95 0.45
BALANCE 12.92
*kt **x *1462
REF»: 000000
PURCHASE: 12.92
CASHBACK: 0,00
Prescribed by State Roard of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 7995)
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
I-i Purchase Order No.
Engineering Department
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
purchase 5113/08 Envirosca e Presentation $12.92
Forest Dale Elementary School 5/14/08
Total
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
VOUCI.'ER NO. WARRANT NO.
ALLOWED 20
6T���rl�et#
IN SUM OF
Engineering Department
$12.92
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
2 9VII(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
zb 2
i nature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund