205415 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 361329 Page 1 of 1
ONE CIVIC SQUARE CLAY CAMPBELL
CARMEL, INDIANA 46032 9003 MAX COURT CHECK AMOUNT: $75.98
FISHERS IN 46037 CHECK NUMBER: 205415
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 122311 47.48 OTHER EXPENSES
651 5023990 122311 28.50 OTHER EXPENSES
umine twang i ransacuull LeLail rage 1 01 1
U mibank.com I Help I Sign Oft
I i :II I
F
c Transfer Funds Pay Bills Send Money Customer Service Alerts Apply for products
m
Account Overview Transaction Detail
Account Activity Your transaction details were saved successfully. You may chance the note or
Online Statements category for this transaction at anytime.
Download Transactions
Manage Categories Completed On: 12/23/2011
Create a banking report Description: POS PURCHASE POS PURCHASE TERMIN_4L 00000190
SOU JCPENNEY STORE 061 INDIANAPO IN 12 -23 -11
9:57 AM SEQ 135764005477
Amount: $81.30
Transaction Type: WITHDRAWAL
m pw
's Online Banking
Guarantee personal Note: Clay's work pants
Category: Not Categorized
Previous transaction Next transaction Return to Account Activity
Ho•.i do i? Glossary PAQs
1 3 ;[f.i
Banking deposit and loan products and services are provided by BMO Harris Bank N.A., Member FDIC. M &I is a trade name used by BMO Harris Bank N.A.
and its affiliates. Copyright 2011, BMO Financial Corp., All Rights Reserved. Advertising Disclosures Site Disclaimers I Your Privacy
�a
M 0 p�
v C7 O C p
–s o sv tQ o v m --t cn Cl)
m n x m t D m Q x CU (D m o v c' co Z o —y cn N
x X O O ni
yj
N X ZJ tit v W O
Q) 7 t o '7 x v O tv X O O 0 v (Dm n CD O CD
O U1
Z Q >f rt N X G
tD -O �-4 W Z 01
>E m E 00 r-F '3 --4 C:)
l� o 3 �r+m C 3 -3 m �W 3 O 000 WZ— �iG�'.:. .0) (n �E 0370 4 O O a1 N O c C31 0)
r �HO�m
V 0 C m N �i C O
O O Z CD
CTI :Z
CD
Z x D N 'CF! Gb M t rnr_M
(h 't O -oh O O O O D O O O r --mj..
O� O X O
ZT
rt Co O X
CD x CD L31 N Cl) W co G:
N f W 01 CD C� iv ca cfl c� v i
c1
q
httnsJ/ citing. ihanking-s erviceS. com/ cih/C FRMa ingervlet /TransactionT)etai]Cnnfirm /I ?/?.()19
FoPrescrd by rm No. 301 S'( CCOUnts ACCOUNTS PAYABLE VOUCHER
Form 301'(Rev. 1995)
TO
ADDRESS
Invoice Date Invgice,humber Item Amount
—r.
I 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
19
Signature Title
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.
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
SANITATION DEPARTMENT A
CARMEL, INDIANA
c 1iii CAtMp 6e l Favor Of
tai; i �ie5 t
Total Amount of Voucher
l Deductions
7200• o 7 2 5 c7
Amount of Warrant
Month of 19
Acct.
VOUCHER RECORD No.
Collection System
Operation
Plant
Commercial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts Merchandi
Total
Allowed
Board Members
Filed
BOYCE FORMS SYSTEMS 1- 800 382 -8702 325
Online Banking: Transaction Detail Page 1 of 1
mibank.com I Help I Sign Off
owl Online Banking
6 secure Online 5esst:in Transfer Funds Pay Bills Send Money Customer Service Apply for Products
Account Overview Transaction Detail
Account Activity Your transaction details were saved successfully. You may change the note or
Online Statements category for this transaction at anytime.
Download Transactions
Manage Categories Completed On: 12/23/2011
Create a banking report Description: POS PURCHASE POS PURCHASE TERMINAL 00000190
SOU JCPENNEY STORE 061 INDIANAPO IN 12 -23 -11
9:57 AM SEQ 135764005477
Amount: $81.30
Transaction Type: WITHDRAWAL
Online Banking Personal Note: Clay's work pants
Guarantee
Guarantee
Category: Not Categorized
z Viety bettiils
Previous transaction Next transaction Return to Account Activity
How do I? Glossary FAQs
BMO A part of 8M0 Financial Group
Banking deposit and loan products and services are provided by BMO Harris Bank N.A., Member FDIC. M &I is a trade name used by BMO Harris Bank N.A.
and its affiliates. Copyright 2011, BMO Financial Corp., All Rights Reserved. Advertising Disclosures Site Disclaimers I Your Privacy
n
mut'arsr
LENDER
https: /cibng. ibanking services. com/ cib/ CEBMainServlet /TransactionDetailConfirm 1/12/2012
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T1006
CAMPBELL, CLAY Purchase Order No.
CARMEL UTILITIES Terms
Due Date 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201' 122311 $47.48
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
Date Officer
VOUCHER 113461 WARRANT ALLOWED
T1006 IN SUM OF
CAMPBELL, CLAY
CARMEL UTILITIES
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
122311 01- 6200 -07 $47.48
Voucher Total $47.48
Cost distribution ledger classification if
claim paid under vehicle highway fund
ul Invy
XPENNEY 0218 -8
6020 E.'182ND' STREET
CASTLETON SO"MALL
INDIANAPOLIS,IN 46250
317- 849 -6500
523/4173/117310 RT 559 RELAX /STRT
UPC No. 05217707371
QTY 1 54.00
Sale Disc -16.01
Iota] Discounts -16,01
Discounted Price 37.99
Net Sales /Return Value 37.99T
523/4173/107410 RT 559 RELAX /STRT
UPC No. 039307738132
OTY 1 54.00
Sale Disc -16.01
Total Discounts -16.01
Discounted Price 37.99
Net Sales /Return Value 37.99T
Subtotal 75.98
Sales .Tax 7.0000% 46250 5.32
Total 81,30
Total Items Sold: 2
Total Items Returned: 0
Your total Savings Today: 32.02
DEBIT CARD 81x30
XXXXXXXXXXXX7565 /06136200 M
Cardholder acknowledges receipt of
goods /services in the amounT shown and
agrees to pay for them according to their
card agreement.
W \kl
Store: 0218 Term: 190 Tran: 1255
Date: 12/23/11 Time: 09:57 AM Assoc: 0518
Holiday Portraits, No sitting fees!
2 free enhanced sheets, $3.99 adnl. sheets
Details at studio. Exp. 1/18/12 PC1813618
71YCY(71 X71 K717C 71 yC 7171717171 Y(7t 7171 iC 71 Y(71 NYC �71X X11'x XYf Y(71 Y(xX X7171
jcpenney accepts returns /exchanges within
90 days of original purchase.
Return privileges for this receipt expire
on:
03/21/2012
Returns without a receipt and receipted or
over 90 days will be refunded at the
lowest on sale price within the last 30
days, and be given in the form of a
,jcpenney Merchandise Return Voucher.
r,
Ask an associate br see jcp.com for a copy
of the full returri policy.
07171
)r 7C 7171 YC 71 X7171 K7171'X7171'X 7t 7t'K7CYC'X'X>r %1170 7C 71 )1 Y(YC 7171 K'X 717071'KX
Tell us about your shopping'experience at
www.jccp.cam /survov
Type directly into the address line.
Do not use web search to access.
Please see back of receipt for details.
Access Code:0218 190 1255 122311 0957 1
Access code valid for 7'days
XXXXXXX X'X XXXX �'X XXXX
XXXXXXXXXXXXXXXXXXXXi1XXXXXXXXXXXXXXX
In at)cp.com
II VIII illlll VIII IIIIIIIII IIII IIIIIIII IIIIIII II IIIIIIIIIiII
12231102180190125500
Llena nuestra encuesta en jcp.com /survey y recibe un cup6n
de 15% DE DESCUENTO EN TU PROXIMA COMPRA
'Valido en una compra realizada durante los pr6ximos 30 dies.
Debes linar la encuesta en el transcurso de 7 dias posterloes a
la compra. Aplican algunas exclusiones.
Consulta todos los terminos y condiciones en jcp.com/survey
tell us about- your
shopping experience
complete our survey
and receive a coupon for
a one day shopping spree
f f
Y�.
s� t
your next purchase*
cannot be combined with other savings offers.
log in by typing
jcp.com /survey
in your browser
Avoid using the search feature of your
internet browser
as there are many surveys not authorized
by JCPenney.
Only one survey per household may be
completed in any 30 day period. Survey must be
completed within 7 days of purchase.
'Valid on purchase within next 30 days. Some exclusions apply.
Complete terms and conditions available on our survey website.
EIMEME UA
SUSTAINED EXCELLENCE
G
Llena nuestra encuesta en jcp.com/sS ey y recibe un cup6n
de 15% DE DESCUENTO EN TU PROXIMA COMPRA
'Valido en una compra realizada durante los pr6ximos 30 dias.
Debes linar la encuesta en el transcurso de 7 dias posteroes a
la compra. Aplican algunas exclusiones.
Consulta todos los terminos y condiciones en jcp.com/survey
tell us about your
shopping experience
complete our survey
and receive a coupon for
a one day shopping spree
10
your next purchase*
cannot be combined with other savings offers.
log in by typing
jcp.com /survey
in your browser
Avoid using the search feature of your
internet browser
as there are many surveys not authorized
by JCPenney.
Only one survey per household may be
completed in any 30 day period. Survey must be
completed within 7 days of purchase.
Valid on purchase within next 30 days. Some exclusions apply.
Complete terms and conditions available on our survey website.
r�ranrrnracv� ran n