203776 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 362295 Page 1 of 1
ONE CIVIC SQUARE DAVID BARNES
i CHECK AMOUNT: $19.99
CARMEL, INDIANA 46032 5634 RIDGE HILL WAY
AVON IN 46123 CHECK NUMBER: 203776
CHECK DATE: 11/21/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4239099 19.99 OTHER MISCELLANOUS
City Form No 201 (Rev. 1995)
IOUNTS PAYABLE VOUCHER
CARMEL CARMEL 260 W CA CITY OF CARMEL
RMEL DR
CARMEL, IN 46032
311.575.8588 ist show: kind of service, where performed, dates service rendered, by
11/16/2011 09 :33:53 per hour, number of units, price per unit, etc.
Me 6znt ID; )0()OiXXXX0880
Device ID: 1111
Terminal ID. PD04, l
Purchase Order No.
CREDIT CARD Terms
MC SALE
CARD XXXXXXXXXXXX8284 Price Date Due
TRANS 002 17100 blue
Batch Description Amount
9 1 $13.00 (or note attached invoice(s) or bill(s))
Approval Code: 035822 1 $6.99 T
TRANS ID: MCSOZLEJ41116 total $19.99
Entry Method: Swiped $0.49 replacement for City owned bicycle 2
_Approved: _Online ii $20.48
SALE AMOUNT Z0 48 n_policy
CUSTOMER COPY er set forth to
and agree that
to vehicle or
ft or any other
cause uCyofw yuw wr uu U u, o ,y „v,uys caused by
unavailability of parts or delays in parts shipments by
supplier or transporter. I hereby grant you and /or your
employees permission to operate the vehicle herein
described on the streets or elsewhere for the purpose of
testing and /or inspection. An express mechanic's lien is
hereby acknowledged on above vehicle to secure the Total Total 20.4$
amount of the repair thereto.
Signature: ce(s), or bill(s), is (are) true and correct and I have audited same in accordance
Carmel City Hall
Thank You Carmel City Hall!
1111111111( 11111111111 U Clerk- Treasurer
II 50 0 0 00 I 12
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VOUCHER NO. WARRANT NO.
y ALLOWED 20
Dave Barnes
IN SUM OF
Engineering Dep artment
8 H� 99
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
n/a rUa 22 00 42 ,$2A -44 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
ignature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund