176662 09/02/2009 vswoOm aaoo1u Pa 1 of 1
C��C�FCA�K0EL 8a
ONE CIVIC SQUARE SARAH BARNES
C*nMsL. INDIANA 4onou mnos,^�*ar CHECK AMOUNT: $100.00
FISHERS IN 46038 onsoK muMosn: 176662
CHECK DATE: 9/2/2009
,"DEPARTMENT AocouwT PO NUMBER INVOICE NUMBER xmoumT osaoR|PT|om
5023990 100.00 GAZEBO REFUND
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
I n invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
lihom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
�a-) Qom- e— S Purchase Order No.
�6 75 E 44, :5+ Terms
F e, r 03 S Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9- a- o GCG� Sa 1
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. WARRANT NO.
ALLOWED 20
IN SUM OF
F r S e, r 5 2 A 3
ON ACCOUNT OF APPROPRIATION FOR
n
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
D 1 5 D2.349v 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
20
uff 'W"'17
i
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund