179376 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363566 Page 1 of 1
ONE CIVIC SQUARE SCOTT PONGRATZ
CARMEL, INDIANA 46032 5535 E 131ST STREET CHECK AMOUNT: $200.00
;von CARMEL IN 46033 CHECK NUMBER: 179376
CHECK DATE: 11/11/2009
D EPARTMENT ACCO PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 200.00 OTHER CONT SERVICES
Scott Pongratz
5535 East 131St Street INVOICE
Carmel, IN 46033
Invoice Number: 0025
Invoice Date: Nov 8, 2009
Customer Information:
Billing Address: Shipping Address: Same
Company: Carmel Fire Department Company.
Name: Name:
Address: Address:
City/State/Zip Carmel IN City/State/Zip
Shipping Method: I None
Order Information:
Hours Date and service preformed; Hourly Rate Amount
8 November 13, 2009 25.00 $200.00
Setup and Tear down and for Public Speaker
AV Support
Subtotal: $200.00
Tax: N/C
Shipping:
Grand Total: $200.00
Notes:
Technical services for even at Northview Christian Life Church
VOUCHER•NO. WARRANT NO.
ALLOWED 20
Scott. Pong ratz
IN SUM OF
5535 E. 131 st Street
Carmel, IN 46033
$200.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 0025 43- 509.00 $200.00 1 hereby certify that the attached invoice(s), or
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
NOV 9 2009
A
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
0025 $200.00
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