159426 05/14/2008 i
CITY OF CARMEL, INDIANA VENDOR: T361253 Page 1 of 1
ONE CIVIC SQUARE BRAD JOHNSON
,a CARMEL, INDIANA 46032
319 S UNION ST CHECK AMOUNT: $100.00
WESTFIELD IN 46074 CHECK NUMBER: 159426
CHECK DATE: 5114/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100.00 GAZEBO REFUND
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Prescribed by Slate 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
✓i Sa Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
ra_ O An so fao%
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
0 r1 so 4 IN SUM OF
S U fl o il 5-�.
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
D 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
Sign urn
J
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund