177099 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 363333 Page 1 of 1
ONE CIVIC SQUARE ATOMIC RANCH
CHECK AMOUNT: $98.00
CARMEL, INDIANA 46032 ATTN: MICHEUE GRINGERI- BROWN
3125 SE REX STREET
CHECK NUMBER: 177099
PORTLAND OR 97202
CHECK DATE: 9!1512009
DE PARTMEN T A CCOUNT PO NUMBER INVO NU T AM OUNT D ESCRIPTION
1160 4355200 2198 98.00 SUBSCRIPTIONS
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Ea 3125 5E Rex $t Portland, OR 97202 (p) 503 771 4171 (f) 503 771 4172
o editor@atomic- ranch.com atomic- ranch.com
MIDCENTURY MARVELS
INVOICE S
City of Carmel- ATTN Darrell Norris Date: 9/2/09
City Hall 3rd Floor Invoice #2198
1 Civic Sq
Carmel IN 46032
Item Quantity Total
Atomic Ranch Summer 2009 #22 25 Cop ies $87.00
Shipping $11.00
Total Due $98.00
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`Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
9/14/09 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
A tomic Ranch Purchase Order No.
Attn: Michelle Gringeri —Brown
3 125 SE Rex Street Terms
P ortland OR 97202 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/2/09 2198 25 copies of Atomic Ranch Magazine $98.00
Total $98.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Atomic Ranch IN SUM OF
Attn: Michelle Gringeri -Brown
3125 SE Rex Street
Portland OR 97202
98.00
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4355200
Subscriptions
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. l hereby certify that the attached invoice(s), or
2198 4355200 $98.00 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
200
Signatu
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund