174785 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00352705 Page 1 of 1
ONE CIVIC SQUARE CARMEUCLAY SAFE LOCK
CARMEL, INDIANA 46032 6468 W BROADWAY CHECK AMOUNT: $140.00
Micori MCCORDSVILLE IN 46055 CHECK NUMBER: 174785
CHECK DATE: 7/22/2009
DEPARTMENT ACCO PO NUMBER INVOICE NUMB J AM OUNT DE
1207 4350100 140.00 BUILDING REPAIRS MA
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CARMEL/CLAY SAFE LOCK
6468 W. Broadway
McCordsville, IN 46055
Phone 335 -2726
"PAY TO THIS STATEMENT OR INVOICE
SOLD BY DATE
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NAME
ADDR SS
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CITY
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CASH C>CHARGE MDSE. RET'D
C.O.D. PAID OUT CHECK
OUAN. DESCRIPTION AMOUNT
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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.
Payee LY-4 Oaf rael Purchase Order No.
lid l.V Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
`1 '1 ca a
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
IN SUM OF
O CCOUNNT� OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
5 01 ill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
J 20
Si nature
Tit e
Cost distribution ledger classification if
claim paid motor vehicle highway fund