164792 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 00351404 Page 1 of 1
ONE CIVIC SQUARE MARC KLEIN
CARMEL, INDIANA 46032
CHECK NUMBER: 164792
CHECK DATE: 1011612008
DEPA ACCOUNT PO NUMBER IN NUMB AMOUNT DESCRIPTION
;1110 4231400. 81.26 GASOLINE
k
Sheetz
'9/24/2008 1:05
AM
Sheetz 4353
5400 Campbells Run R
oad
Pittsburgh, Pa 1520
5
(412) 787 -1190
Store: 353
Appr:00529
Pump No: 03
un'-.eaded $3.599/G
Vo lime 22.578 Ga L
Gas Total.' $81.26.
Total $81.26
XXXXXXX
09/24/2008 01:02:18
Thanks for your
business.
Pro9cribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
t
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
Marc A. Klein Purchase Order No.
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/24/08 reimburse Det. Marc Klein for gasoline 81.26
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
Marc A. Klein IN SUM OF
81.26
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
D EFT or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 314 81.26 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
October 9 20 08
Signature
Chief of Police
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund