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167376 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 356837 Page 1 of 1 ONE CIVIC SQUARE MICHELLE KRCMERY CARMEL, INDIANA 46032 433 AUTUMN DRIVE CHECK AMOUNT: $3,448.40 CARMEL IN 46032 CHECK NUMBER: 167376 CHECK DATE: 12/23/2008 DEPA RTMENT ACCOUNT P NUMBER INVOIC NUMBE AMOUNT DESCRIPTION 1160 4128000 3,448.40 TUITION REIMBURSEMENT I Unofficial Transcripts Page 1 of 2 Report Results Return Student Unofficial Transcript with Enrollment Indiana University Purdue University Indianapolis Name Krcmery,Michelle Anne Student ID 0002328371 SSN Birthdate 06- 04 -XXXX Address 433 Autumn Drive Carmel, IN 46032 United States Print Date 12 -18 -2008 Request Nbr 006775153 Beginning of Graduate Record Summer 2007 Indianapolis Program Business Graduate Program Business Grad Nondeg Course Title Hrs Grd BUS -K 501 QUANTITATV TOOLS FOR BUSINESS 1.50 S BUS -A 501 FINANCIAL ACCTG REPORTING 1.50 S Semester: IU GPA Hours: 0.00 GPA Points: 0.000 Hours Earned: 3.00 GPA: 0.000 Cumulative: IU GPA Hours: 0.00 GPA Points: 0.000 Hours Earned: 3.00 GPA: 0.000 Fall 2007 Indianapolis Program Business Graduate Course Title Hrs Grd BUS -A 524 MANAGING ACCTG INFO DEC MAKING 3.00 B BUS -J 501 DEVELOP STRATEGIC CAPABILITIES 1.50 A- BUS-G 502 MANAGERIAL ECONOMICS 1.50 B+ BUS -X 511 SEMINAR IN MGMT ISSUES: 1.50 A Semester: IU GPA Hours: 7.50 GPA Points: 25.500 Hours Earned: 7.50 GPA: 3.400 Cumulative: IU GPA Hours: 7.50 GPA Points: 25.500 Hours Earned: 10.50 GPA: 3.400 Spring 2008 Indianapolis Program Business Graduate Course Title Hrs Grd BUS -F 523 FINANCIAL MANAGEMENT 3.00 B+ BUS -X 522 ENTERPRISE LECTURES 1.50 S BUS -G 511 MICROECONOMICS FOR MANAGERS 1.50 B+ BUS -G 512 MACROECONOMICS FOR MANAGERS 1.50 B+ Semester: IU GPA Hours: 6.00 GPA Points: 19.800 Hours Earned: 7.50 GPA: 3.300 Cumulative: IU GPA Hours: 13.50 GPA Points: 45.300 Pc,1 2oog i r b, https:Hiuself.iu.edu/psc /SSERV/ SISSELFSERVICE /HRMS /c /SA_LEARNER_SERVIC... 12/18/2008 Unofficial Transcripts Page 2 of 2 Hours Earned: 18.00 GPA: 3.356 Summer 2008 Indianapolis Program Business Graduate Course Title Hrs Grd BUS -S 555 INFO TECHNOLOGY FOR MANAGERS 1.50 A BUS -W 519 KNOWLEDGE MANAGEMENT 1.50 A Semester: IU GPA Hours: 3.00 GPA Points: 12.000 Hours Earned: 3.00 GPA: 4.000 Cumulative: IU GPA Hours: 16.50 GPA Points: 57.300 04- Ho Earned: 21.00 GPA: 3.473 C Fall 2008 Ind ana polist Program Business Graduate Course Title Hrs Grd A11 C�gCl�S 4x�de_ BUS -M 5'0'1 STRATEGIC_MARKE,T.ING_MANAGEMEN 0 A— J r'BUS P 501 OPER'P TIONS MANAGEMENT 3_._0_0 B+ 1 X Semester: IU GPA Hours: 6.00 GPA Points: 21.000` fe�m �u�Csn� Hours Earned: 6.00 GPA: 3.500 Gam[ Le�cC \a�� Cumulative: IU GPA Hours: 22.50 GPA Points: 78.300 Hours Earned: 27.00 GPA: 3.480 Spring 2009 Indianapolis Program Business Graduate Course Title Hrs Grd BUS -J 506 LDRSHIP ETHICS BUS ENVIRONMT 3.00 NR BUS -M 503 APPLIED MARKETING RESEARCH 3.00 NR BUS -M 595 SPECIAL TPCS IN MARKETING: VT 1.50 NR Course Topic(s): MARKETING ENGINEERING Semester: IU GPA Hours: 0.00 GPA Points: 0.000 Hours Earned: 0.00 GPA: 0.000 Cumulative: IU GPA Hours: 22.50 GPA Points: 78.300 Hours Earned: 27.00 GPA: 3.480 Student Graduate Program Summary GPA Hours: 22.50 Transfer /Test Hours Passed: 0.00 Hours Earned: 27.00 Points: 78.300 GPA: 3.480 Indiana University Graduate Summary IU GPA Hours: 22.50 Transfer /Test Hours Passed: 0.00 Hours Earned: 27.00 Points: 78.300 GPA: 3.480 Academic Objective as of Last Enrollment Business Graduate Marketing MBA Return Go to Top C;��.cL� 1�o��r 5 re..• n, hu.rs- �nne��+ a� https: /iuself iu.edu/pse /SSERV/ SISSELFSERVICE /HRMS /c /SA_LEARNER_SERVIC... 12/18/2008 QuikPAY(R) Transaction Details Page 1 of 1 Michelle Anne Krcmery 0002328371 Privacy Policy 0 Contact Us Log Off Message Board Transaction Details Payment Profiles Back Authorize Payers Pay User Preferences Payment made by Michelle Anne Krcmery View Accounts Confirmation Number: 2848609 Make Payment Date Aug 17, 2008 at 3:40 PM, EDT Transaction History Effective Date: Aug 18, 2008 Primary User Id: 0002328371 Primary User Name: Michelle Anne Krcmery Account: Indianapolis Amount: $3,440.00 Cardholder's Name: Michelle A Krcmery Payment Method: Address Info 433 Autumn Drive Carmel, IN 46032 Co Info: (317)697 -9669 (daytime phone) Copyright 2001. Nelnet Business Solutions, Inc. All rights reserved. var�s�yn QuikPAY is a registered trademark of Nelnet Business Solutions, Inc. soeu.na r VEAFY https:Hquikpayasp.com /iu/qp/ history/ submitPaymentHistory .do ?transactionld= 2848609 12/12/2008 SF Account Activity Page 1 of 1 Michelle Krcmery Student Center Account Inquiry summary II activity II charges due I� payments I` anticipated financial aid Account Activity Account Activity provides a list of all bursar transactions in date order. You may change the date range to review transactions processed prior to the current year. If you have bursar accounts at more than one campus, use the drop -down arrow to review individual campus bursar transactions. View by Indianapolis From i07 /01� /2008 a+ To 10/15/2008 51, go Transactions Find I View All First 1 -3 of 3 ®j Posted Date 11tem I Chargel Payment Refund 08/17/2008 Payment by Web 3,440.00 1 Credit Card IIII 07/28/2008 MBA Prof 20000 r Development C Resident Grad 07/28/2008 Fees (Business) 3,240.00 First 1 -3 of 3 Last i MAKE A PAYMENT Account Inquiry Summary Activit Charges Due Payments Anticipated Financial Aid Student Center https: iuself. iu. edu/ psc /SSERV /SISSELFSERVICE/HRMS /c /SA LEARNER SERVIC... 10/15/2008 City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head np 'or to commencement of course.) Employee Name p mP V Department omn)L.u_ r� Ke-10kli ;YES SSN Date 2Dd5 Educational Institution* �r t Q rta l r� i de r S I A y �uX -C L�t� 1 d� C _S +`I Z_ �d 0. V-\ a f r o i S Name of Course 1�1.i S G Starting Date of Course (month/day /year) 2�2_1 /2-0 By signing below, I signify that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for this course. The tax status of reimbursement payments is subject to federal law, which may change from time to time. Employee Signature '--M t, '16V Date 1 Part II (to be completed by Department Head) (Submit to Human Resources) By signing below, I certify that the applicant will have been employed full -time by the City for at least one (1) year prior to the commencement of the course, and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the beginning of the course. The final claim will be paid from my department's budget, subject to the terms of Section 2 -59 of Carmel City Code. r Department Head Signature Gj� xf I 0,4 Date Part III (to be completed by Director of Human Resources) Final Approval c�_ Ac Date V g 0 If denied, reason for denial The tuition reimbursement program covers only full- semester courses offered through a degree granting institution accredited by the North Central Association of Colleges and Schools or an equivalent regional accreditor. An application will not be considered complete unless a course description from the school's literature is attached. Rev June 07 City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head np �or to commencement of course.) Employee Name ec y Department C, M rnuf� Ke a- om s SSN Hire Date to 2+ 5 Educational Institution* u n c� I,l n JQ f 5 v i�v.0 U21 n V2 is i v cc n A Pp 5 NameofCourse Starting Date of Course (month/day /year) By signing below, I signify that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for,this course. The tax status of reimbursement payments is subject to federal law, which may change from time to time. Employee Signature rn v a Date 2 Part II (to be completed by Department Head) (Submit to Human Resources) By signing below, I certify that the applicant will have been employed full -time by the City for at least one (1) year prior to the commencement of the course, and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the beginning of the course. The final claim will be paid from my department's budget, subject to the terms of Section -59 of Carmel City Code. C Department Head Signature 'li( Date o S 200 Part III (to be completed by Director of Human Resources) Final Approval C.� Gm-.�- Date 5 0 If denied, reason for denial The tuition reimbursement program covers only full- semester courses offered through a degree granting institution accredited by the North Central Association of Colleges and Schools or an equivalent regional accreditor. An application will not be considered complete unless a course description from the school's literature is attached. Rev June 07 Print Page 1 of 2 From: auto confirm @amazon.com (auto confirm @amazon.com) To: mkrcmery@yahoo.com Date: Tuesday, .August 26, 2008 4:05:08 PM Subject: Your Order with Amazon.com ad °°z o .co �vlEw CART I WISH LIST I YOUR ACCOUNT) I HELP Thanks for your order, Michelle Krcmery! Want to manage your order online? If you need to check the status of your order or make changes, please visit our home page at Amazon.com and click on Your Account at the top of any page. Purchasing Information: E -mail Address: mkrcmery @yahoo.com Billing Address: Shipping Address: Michelle Krcmery Michelle Krcmery 433 Autumn Drive City of Carmel Carmel, IN 46032 One Civic Square United States Carmel, IN 46032 United States Order Grand Total: $125.98 Get the Amazon.com Visa Card or the Amazon.com Business Visa Card instantly and automatically get $30 back after your first purchase. Plus get up to 3% rewards. Order Summary: Shipping Details: murphys_iaw_33 Order 103 8498007 7333842 Shipping Method: Shipping Preference: Group my items into as few shipments as possible Subtotal of Items: $118.99 Shipping Handling: $6.99 Total for this Order: $125.98 Delivery estimate: August 29, 2008 September 8, 2008 Shipping estimate for these items: August 27, 2008 August 28, 2008 n 1 "Marketing Management (13th Edition) (Marketing Management)" Philip Kotler; Hardcover; $118.99 Sold by: murphys law 33 Where can I get help with reviewing or changing my orders? http://us.mgl.mail.yahoo.com/dc/launch?.rand=dpsl9emmskoOg 10/15/2008 Print Page 2 of 2 To learn more about managing your orders on Amazon.com, please visit our Help pages at amazon.com/help/orders/. Please note: This e -mail message was sent from a notification -only address that cannot accept incoming e-mail. Please do not reply to this message. Thanks again for shopping with us. Amazon.com Earth's Biggest Selection Prefer not to receive HTML mail? Click here http://us.mgl.mail.yahoo.com/dc/launch?.rand=dpsl9emmskoOg 10/15/2008 Harvard Business Online Page 1 of 2 qm+iAI1i/ARD Home Sign In Contact us i careers s BUSINESSF O RE O VCATOtrs vunuswur�, My Cart (0) Harvard Business Review Newsletb C Harvard h Business School Cases Conferen My Account fly My Library Harvard Business Press Corporal �1 My Courses 4 Order Details 0 Payment Confirm i Tips Please Note: We will be closed Monday, Sept. 1st. Orders received Friday, Aug. 29th. will ship from our warehouse beginning Tuesday, Sept. 2nd. Please plan your shipping requirements accordingly. Note: Our hours of operation M are: Monday Thursday 8AM -6PM and Friday 8AM 21 Eastern Time. THANK YOU GENERAL EDUCATOR DISCIPLINES Your order has been received. I Accounting control Your web id number is d345965913. Please use this number when conducting any correspondence with us Business about your order. You will also receive an email confirmation shortly. 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See our FAQ for more information. j Human resources ORDER INFORMATION management y Management of Customer Information Billing Information information systems MICHELLE KRCMERY Michelle Krcmery Marketing 433 AUTUMN DRIVE 433 Autumn Drive Negotiations CARMEL IN Carmel, IN United States United States Operations 46032 46032 management (317) 848 -2537 (317) 848 -2537 Organizational Email: mkrcmery @yahoo.com behavior leadership Payment Method ethics i ITEM INFOR Courses https: harvardbusinessonline .hbsp.harvard.edu /b02 /en/ commerce /checkout_confirm.jhtml? requested =l28563 8/29/2008 Harvard Business Online Page 2 of 2 To view details related to your courses or to change the products within your course, click on the course name or go to My Courses. Course Total Price KSOB Marketing Management $43.45 The Xbox Launch in Korea Three Questions You Need to Ask About Your Brand Vans: Skating on Air ThoughtWorks (A): Targeting and Positioning Basics for a Services Firm Starbucks: Delivering Customer Service Saxonville Sausage 1 Marketing Is Everything Market Segmentation, Target Market Selection, and Positioning c Atlantic Computer: A Bundle of Pricing Options Mountain Man Brewing Co.: Bringing the Brand to Light High- Performance Marketing: An Interview with Nike's Phil Knight Order Subtota $43.45 Surcharge: $0.00 Tax TBD Shipping and Handling: $0.00 Grand Total: $43.45 E Careers Abou Us +Privacy Policy (Permissions Copyright Information +Harva Business School https:// harvardbusinessonline .hbsp.harvard.edu/b02 /en /commerce checkout _confirm.jhtnil ?_requestid 128563 8/29/2008 Print Pagel of 2 From: auto confirm @amazon.com (auto confirm @amazon.com) To: mkrcmery@yahoo.com Date: Sunday, August 17, 2008 4:09:23 PM Subject: Your Order with Amazon.com amaxon.com VIEW CART I WISH LIST I YOLIRACCOUld7 I HELP Thanks for your order, Michelle Krcmery! Want to manage your order online? If you need to check the status of your order or make changes, please visit our home page at Amazon.com and click on Your Account at the top of any page. Purchasing information: E -mail Address: mkrcmery @yahoo.com Billing Address: Shipping Address: Michelle Krcmery Michelle Krcmery 433 Autumn Drive City of Carmel Carmel, IN 46032 One Civic Square United States Carmel, IN 46032 United States Order Grand Total: $38.97 Get the Amazon.com Visa Card or the Amazon.com Business Visa Card instantly and automatically get $30 back after your first purchase. Plus get up to 3% rewards. Order Summary: Shipping Details xyzbooks4u Have questions about this order? Please contact the seller. Order 058 3181482- 9028520 Shipping Method: Standard Shipping Subtotal of Items: $34.98 Shipping Handling: $3.99 Total for this Order: $38.97 Shipping estimate for these items: August 20, 2008 4 ia 1 "Operations Management for MBAs, 2nd Edition" Jack R. Meredith; Paperback; $34.98 Sold by: xyzbooks4u Where can I get help with reviewing or changing my orders? To learn more about managing your orders on Amazon.com, please visit our Help pages at http://us.mgl.mail.yahoo.com/dc/launch?.rand=2ulu5lcnblkf2 8/26/2008 M501 Strategic Marketing Management Syllabus Spring 2008 Carmel Cohort As of 8/5/08 Class Times: Tues. 5:45- 8:25pm Dr. M. Kim Saxton Class Location: Carmel Life and Learning Center Office: BS 4041 Office Hours: Tues. 4- 5:45pm by appt. Phone: 274 -0167 E -mail: mksaxton(a)-iuoui.edu Class Materials: Text Kotler Keller, Marketing Management, 13e The 13 edition is different from the 12 edition. In case you have accidently picked up the 12 edition, I have included page numbers for both editions in the syllabus. This textbook is the premier textbook in the marketing field. As such, it is a bit of an encyclopedia. Students sometimes complain that there is too much information covered in the textbook. As a result, the syllabus identifies specific pages that will be the focus of each week's class. However, you should try to read the entire chapter assigned each week. Some students believe that reading the text is not important as we will cover the most important topics in class discussion. These students, however, tend not to do as well on exams and assignments as those who make sure they work through the textbook before class. Articles Cases In addition to the text, there are a number of articles and cases that will be covered in class. These additional resources can be found in 3 places: 1. OnCourse A small number have been uploaded on the "Assignments" tab in OnCourse 2. University Library some copyrights do not allow me to upload the articles into OnCourse. Instead, you have to retrieve the articles from the electronic University Library databases. This can be done 2 ways. If you are on campus, you can use CTRL +Click on the links in the syllabus to get directly into the University Library databases. If you are offsite, you will have to use the article information to find the article yourself links to "proquest" are in the database ABI /Inform and "web.ebscohost" is Business Source Premier. You should plan to download all of the articles at once the first time you are on campus this semester. 0 3. HBR Some articles and cases have to be purchased directly from HBR. I have set up a course online at HBR where you can order all the materials. It is your responsibility to purchase these materials directly from HBR. We will also use the Benihana case which should be available to you from your P501 course packet. Otherwise, the first HBR item will be used in Week #3. The cases have been organized as an online course at the following link: http• /harvardbusinessonIine hbsi) harvard.edu /relay.ihtmI ?name= co &c= c28638 More specific details on the HBR Online course are included on the last two pages of this syllabus. While it may be a bit cumbersome to go to 3 places to secure all of the course materials, this is the most efficient way to manage costs and availability while abiding by copyright laws. I Page Course Details at Harvard Business Review Online I have created a course area on the Harvard Business Online website where you can order the required materials for this course. Click on the link below to order the course materials. http•// harvardbusinessonline .hbsp.harvard.edu /relay.ihtml ?name= cp &c =c2863 8 If you have not registered with Harvard Business Online, you will be required to do so. This URL will provide you with a list of required materials for use in this course. The products are listed at the bottom of this email. Note that product formats may differ; some may require that a hard copy be shipped to you via air mail. Electronic course materials are in PDF (Portable Document Format) and should be viewed with Adobe Reader, available free at www.adobe.com. Students can access PDF files of course materials via a link on Harvard Business Online for six months from the date of purchase. You will have immediate access to the materials upon placing your order, for subsequent access, you must login to http //harvardbusinessonline.org I hope you find this a convenient way to access your course materials. For technical assistance, please view the Quick Tips section or contact Harvard Business School Publishing at 1- 800 810 -8858 or 617 783 -7700. They are open 8am -6pm Eastern Standard Time. They can also be reached at techhelpAhbsp.harvard.edu COURSE DETAILS Professor Information: Professor Kim Saxton INDIANA UNIV BLOOMINGTON KELLEY SCHOOL OF BUSINESS 1309 EAST 10TH STREET BLOOMINGTON, IN 47405 Phone:3172740167 Fax: 317- 274 -3312 Course Information: Course Name: KSOB Marketing Management Course Number: M501 Student Access URL: hLtp //harvardbusinessonline. hb sp. harvard. edu/rel ay.i html ?name= cp &c =c2 8 63 8 Product 92406 Product Title: High Performance Marketing: An Interview with Nike's Phil Knight Product Type: Harvard Business Review Article Product 9 -504 -016 Product Title: Starbucks: Delivering Customer Service 211Page Product 2085 Product Title: Saxonville Sausage Product 506019 Product Title: Market Segmentation, Target Market Selection, and Positioning Product M303 Product Title: The Xbox Launch in Korea Product R0209F Product Title: Three Questions You Need to Ask About Your Brand Product KEL113 Product Title: ThoughtWorks (A): Targeting and Positioning Basics for a Services Firm Product 502077 Product Title: Vans: Skating on Air Product 2069 Product Title: Mountain Man Brewing Co.: Bringing the Brand to Light Product 2078 Product Title: Atlantic Computer: A Bundle of Pricing Options Product 91108 Product Title: Marketing Is Everything 221Page 4 P501 Operations Management Kelley School of Business, Indiana University Professor Mohan V. Tatikonda Fall 2008 Downtown: Tuesdays 6:00 -9:00 (in BS 2007) Carmel: Thursdays 5:45 -8:45 (in CS 135) Office: BS4044 Phone: 317.274.2751 Downtown Office Hours: Tuesdays 4:30 -5:30 and by appointment tatikond @iu.edu Carmel Office Hours: Thursdays 4:15 -5:15 and by appointment www.MohanTatikonda.com Course Overview This course addresses the management of operations in service and manufacturing organizations. We cover four themes: 1. Process analysis describing processes verbally, numerically and graphically; identifying process types; and determining response times, production capacity and operational constraints and bottlenecks. 2. Oualitymana eg ment quality management frameworks and tools; variance charting and reduction; learning curve assessment; and six -sigma and related programs for systematic improvement of processes. 3. Supply chain mana eg ment the value chain perspective; information sharing within and across organizations; just -in- time /lean operations; materials management; resource planning; and enabling information technologies. 4. Innovation Projects the product innovation process; technology transfer; and operations strategy relating to technological change. This course employs strategic and tactical perspectives, and covers a variety of qualitative and quantitative analytical techniques. Cross cutting workforce and human issues are addressed throughout the course, as are the impacts of operations choices on the natural environment. We consider local, international and multinational business situations. This course relies heavily on case discussion and in -class exercises. Your active participation helps you engage more deeply in the course material and also helps your student colleagues learn from your experiences and insights. Course Materials 1. Operations Management for MBAs 2nd edition, by Meredith and Shafer, 2002, Wiley, ISBN: 0- 471- 00060 -4. 2. P501 Operations Management coursepack. 3. Miscellaneous items posted to Oncourse. Grade Elements Process Essay 10% Due class #6, description of your workplace process, individual work. Midterm Problem Set 15% Due class #8, posted class #6, group work. Term Paper 20% Due class #13, analysis of a real -life operations situation, 8 pages max, original, individual work. Can be turned in earlier. Final Exam 25% Done remotely, 6:00- 8:OOPM on Thursday, Dec. 4` Case study handed out ahead of time, questions given at exam time, individual work. Class Participation 30% Assessed daily. 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. f Payee c c_mcj y Purchase Order No. y�3 Av`mr��l�2 Terms m Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) MSc sc 9 Q 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. /Qg ALLOWED 20 IN SUM OF Los +��A ON ACCOUNT OF APPROPRIATION FOR Mai f s 116c� 'A I Z g 0c0 Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or I I L%o 3 �,y® 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 oF i Witur Title Cost distribution ledger classification if claim paid motor vehicle highway fund