205163 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00353420 Page 1 of 1
ONE CIVIC SQUARE GEORGE W DAVIS
CARMEL, INDIANA 46032 3854 CORNWALLIS LANE CHECK AMOUNT: $30.35
CARMEL IN 46032 CHECK NUMBER: 205163
CHECK DATE: 115/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343003 30.35 TRAVEL LODGING
GREEK TOFIVS PIZZA
1732 E 116TH ST
CARPIEL, IN. 46032
TERMINAL I.D.; 0075420008016403415000
MERCHAHT N: 8016403415
SALE
RECORD 9 INV: 000009
DATE: DEC 27, 11 TIME: 11:15
BATCH: 604
AUTH: 002452
BASE $25.35
TIP
3o.�s
TOTAL
I AGREE TO PAY ABOUE TOTAL AMOUNT
ACCORDING TO CARD ISSUER AGREEMENT
(MERCHANT AGREEMENT IF CREDIT UOUCHER)
CUSTOMER COPY
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/27/11 history project $30.35
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
George W. Davis
IN SUM OF
3854 Cornwallis Lane J 2
Carmel, IN 46032
1
N
)PRIATION FOR
a partment
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
1110 I 43- 430.03 $30.35
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
Wednesday, January 04, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund