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172284 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 069001 Page 1 of 1 i ONE CIVIC SQUARE CRYSTAL FLASH CHECK AMOUNT: $27.00 CARMEL, INDIANA 46032 545 S RANGELINE ROAD CARMEL IN 46032 CHECK NUMBER: 172284 CHECK DATE: 5/13/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 27 GASOLINE CN> 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 Crystal Flash 4667 Purchase Order No. '545 S. Raneline Road Terms ;Carmel, IN $6032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 4/15/09 payment for gasoline 27.00 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 VDUCHER NO. WARRANT NO. ALLOWED 20 C stal Flash �r 67 IN SUM OF 545 S. Rangeline Road Carmel, IN 46032 27.00 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 314 27.00 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 May 8 2009 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund