179628 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 354401 Page 1 of 1
ONE CIVIC SQUARE CROSSROAD REHAB CENTER, INC
INDIANA 46032 4740 KINGSWAY DRIVE CHECK AMOUNT: $100.00
CARMEL
INDIANAPOLIS IN 46205 -1521
CHECK NUMBER: 179628
CHECK DATE: 11/24/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4358200 9680 100.00 SPECIAL INVESTIGATION
DUE DATE° DISC DUE DATE ORDER NO. ORDER DATE SHIP DATE JOB NO.
11/13/2009 11/13/2009 00010556 10/31/2009 11/12/2009
TERMS e. CUSTOMER P.O. NUMBER /CASE NO...
Upon receipt
TX UNIT OF
INTERPRETER /CLIENT'
CL
MEASURE. REQUESTED DELIVERED UNIT PRICE; EXTENSION.
NICOLAI, RANDOLPH 0 HOUR 2.0000 2.0000 50.0000 100.00
Brian Mayes
10/3/2009
4NTERPRETING SERVICE WITH DET
COLLLINS REQUESTED BY MCGEE
-71 -5280
,a
We appreciate your business. Fed ral Tax ID 35- 0869058
TAXABLE NONTAXABLE: FREIGHT SALES TAX MISC. CHARGE TOTAL
0.00 100.00 0.00 0.00 0.00 100.00
DELUXE BUSINESS FORMS 1 +800 328 -0304 0805 WAX 42447V
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
-ti ACCOUNTS PAYABLE VOUCHER
J' 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
Deaf Community Services Purchase Order No.
4740 Kingsway Drive Terms
Indianapolis, IN 46205 -1521 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11 13 0 9680 payment for interpreting ervice
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. WA -RRANT NO.
ALLOWED 20
De &f Community Ser ees�
IN SUM OF
4740 Kingsway Drive
Indianapolis, IN 46205 -1521
100.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 9680 582 100.00 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
November 19 20 09`-
Signature
thief of oli e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund