HomeMy WebLinkAbout169347 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 022560 Page 1 of 1
0 ONE CIVIC SQUARE BATTERIES PLUS CHECK AMOUNT: $658.59
1 CARMEL, INDIANA 46032 PO Box 382
l� MENTONE IN 46539
CHECK NUMBER: 169347
CHECK DATE: 3/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 6195009 317.64 OTHER MISCELLANOUS
1207 4239099 7- 166279 99.98 OTHER MISCELLANOUS
1125 4237000 7- 188156 71.99 REPAIR PARTS
1205 4237000 7- 188183 89.99 REPAIR PARTS
651 5023990 7187554 9.00 OTHER EXPENSES
651 5023990 7188310 69.99 OTHER EXPENSES
IwAppr
Batteries Plus STORE# 6
N�N��o� �N� 7325 Pendleton
Pike Road REG# 62
Indianapolis, IN 46226-5133 TIME: 11335
(317) 543-9302
SAL E S 1 N
Mentone, IN 46539
CLERK, CASH' I
MAE- X Y/ ROBERT
Price Unill— 144 EACH
Price Unit-. 1/4-4 EACH
18 RAYRL123A-1 3V LITHIUM 1PK 3.00 54,,00 Y
Price Unit: 18 EACH
Price Unit- 2 EA C H
BTOTAE -f 317.64
iunature. .00
RECEIVED BY THIS RECEIPT MUST BE PRESENTED my THIS
A 7,17.64
FOR RETURNS AND WARRANTIES. MOUNT
We want you to be completely satisfied with your Batteries Plus purchase. In the event you wish to make use of our return or
warranty policy, the following information reflects the policies of our product manufacturers and will help facilitate your return or
warranty.
Return Policy:
Product returns require a proof of purchase or original receipt.
Cash or credit refunds will be given_ with a proof of purchase receipt up to fourteen (14) days from the date of
purchase i�'d aj�p1 Yf er' h n v4�- etermine to be unused and in a saleable condition.
A check for refuncfs 4 �A ISOr hases of more than $20.00 may be mailed to the customer's home address.
Refuri4 for require a ten (10) day waiting period.
Refunds! 'for puc teases Q& b?eFedif card will,be credited back to the credit card used to make the purchase.
Return's are not applicable to Tech Center rebuilds.
Warranty Policy:
Warranties require a proof of purchase or original receipt.
Product warranty applies to the original purchaser. Warranties are non transferable.
It is Batteries Plus'policy to honor warranty claims within the warranty periods; however,
o Warranty claims will not be accepted on products that are defective due to owner abuse or neglect.
o Warranty claims will not be accepted on products that are defective due to use in applications for which
products are not intended.
A warranty claim may require product analysis by Batteries Plus personnel prior to issuance of credit /replacement.
This process may take up to twenty -four (24) hours.
Specific terms and conditions of warranty policy will vary by product type.
Modifications of these policies, if applicable, will be posted in the store.
For additional information please dial 1- 800 -MR -START (1 -800- 677 -8278) for the store nearest you.
a
Pres`c &d 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
Batteries Plus Purchase Order No.
P.0 BOx 382 Terms
Mentone, IN 46539 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
219/09 6195009 a ent for batteries 317.64
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
B atteries Plus IN SUM OF
P.O. Box 382
Mentone, IN 46539
317.64
ON ACCOUNT OF APPROPRIATION FOR
p olice general fund'_
Board Members
PO# EP
or
DEPT INVOICE NO ACCT /TITLE AMOUNT
I hereby certify that the attached invoice(s), or
1110 6195009 390 -99 317.64 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
February 25 20 09u
kj�,�'j 1)
Signature
Chief of POlice
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
flatteries PILts 007 STORE# 7
BatteriesPlus. +16 1701 E= I h1 -3505 Rd TIME- 11.3
1�� 7 5 8300
Give us your **HISTORY**
S A L E S I N V O I C E
INVOICE NO.
s CITY OF CARME:L STREET s 7- 188310
#1 CIVIC SQUARE H INVOICE DATE
D P 02/18/09
CARMEL, IN 46032
ACCOUNT NO.
T 317/571• -2637 Tax Code.- EXEMP T 5712637
0 0
CLERK CASH CHARGE CREDIT INSTALLED ADJ WFW REC'DACC. 'P.O. NUMBER. SHIP VIA
CMP X NONE
QUANTITY NUMBER DESCRIP C ORE EACH IT EXTENSION TAX Y/N
1 SLI24 -ULT 24 ULTRA 18/65 69.99 690 9- Y
Price Unite 1 EACH
pay from thi invoice*-4
robbie kinkead SUBTOTAL 6 9. 1 9
S i g n at i -t r e° TAX 0
RECEIVED BY THIS RECEIPT MUST BE PRESENTED 69.9
FOR RETURNS AND WARRANTIES.
We want you to be completely satisfied with your Batteries Plus purchase. In the event you wish to make use of our return or
warranty policy, the following information reflects the policies of our product manufacturers and will help facilitate your return or
warranty.
Return Policy:
Product returns require a proof of purchase or original receipt.
Cash or credit refunds will be given with a proof of purchase receipt up to fourteen (14) days from the date of
purchase and apply to merchandise we determine to be unused and in a saleable condition.
A check for refunds of cash purchases of more than $20.00 may be mailed to the customer's home address.
Refunds for purchases made by check require a ten (10) day waiting period.
Refunds for purchases made by credit card will be credited back to the credit card used to make the purchase.
Returns are not applicable to Tech Center rebuilds.
Warranty Policy:
Warranties require a proof of purchase or original receipt.
Product warranty applies to the original purchaser. Warranties are non transferable.
It is Batteries Plus' policy to honor warranty claims within the warranty periods; however,
Warranty claims will not be accepted on products that are defective due to owner abuse or neglect.
Warranty claims will not be accepted on products that are defective due to use in applications for which
products are not intended.
A warranty claim may require product analysis by Batteries Plus personnel prior to issuance of credit /replacement.
This process may take up to twenty -four (24) hours.
Specific terms and conditions of warranty policy will vary by product type.
Modifications of these policies, if applicable, will be posted in the store.
For additional information please dial 1- 800 -MR -START (1- 800- 677 -8278) for the store nearest you.
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CAMEL
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
22560
BATTERIES PLUS Purchase Order No.
PO BOX 382 Terms
MENTONE, IN 46539 Due Date 2/25/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/25/2009 7188310 $69.99
�c
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
12, -1,
Date Officer
VOUCHER 095148 WARRANT ALLOWED
225'60 IN SUM OF
BATTERIES PLUS
PO BOX 382
MENTONE, IN 46539
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
7188310 01- 7202 -06 $69.99
Voucher Total $69.99
Cost distribution ledger classification if
claim paid under vehicle highway fund
Batteries Plus 007 STORE# 7
���N�N��U� 1701 E. 116th St. Ctr Rd. REG# 70
N��Qtt�rN�~��N Carmel, IN 46032-3505 TIME: 10:48
(317)575-8300
Give us your feedback at:
SALES INVOICE
*DUPLICATE COIZIY* INVOICE NO.
L 760 3RD AVE. SW I INVOICE DATE
D SUITE 110 p 02/06/09
'CARMEL, IN 46032 ACCOUNTNO.
T 317/571-2634 Tax Code.- EXEMp 5712634
CLERK CASH CHARGE CREDIT INSTALLED ADJ WFW REC'DACC. P.O. NUMBER SHIP VIA
QUANTITY NUMBER DESCRIPTION CORE EACH ITEM EXTENSION, TAX Y/N
AAPROMO AA BATTERY PROMOTION 3ALE 3.00 9.0 Y
Remit to: Batter! s Plus
P.O. Box 382
Mentone, IN 46E39
Phone: (260) 982-13720
Kevin B SUBTOTAL 9.00
Signature: TAX ob
RECEIVED BY THIS RECEIPT MUST BE PRESENTED PAY
FOR RETURNS AND WARRANTIES. AMOUNT
•1 �3
We want you to be completely satisfied with your Batteries Plus purchase. In the event you wish to make use of our return or
warranty policy,the following information reflects the policies of our product manufacturers and will help facilitate your return or
warranty.
Return Policy:
Product returns require a proof of purchase or original receipt.
Cash or credit refunds will be given with a proof of purchase receipt up to fourteen (14) days from the date of
purchase and apply to merchandise we determine to be unused and in a saleable condition.
A check for refunds of cash purchases of more than $20.00 may be mailed to the customer's home address.
Refunds for purchases made by check require a (10) day waiting period.
Refunds for purchases made by credit card will be credited back to the credit card used to make the purchase.
Returns are not applicable to Tech Center rebuilds.
Warranty Policy:
Warranties require a proof of purchase or original receipt.
Product warranty applies to the original purchaser. Warranties are non transferable.
It is Batteries Plus' policy to honor warranty claims within the warranty periods; however,
Warranty claims will not be accepted on products that are defective due to owner abuse or neglect.
Warranty claims will not be accepted on products that are defective tie 4pihich
products are not intended. 28Z X08 .U."i
A warranty claim may require product analysis by Batteries Plus personnel prioeti /replacement.
This process may take up to twenty -four (24) hours. 0 5T0. Su `11, .enofiq
Specific terms and conditions of warranty policy will vary by product typo.
Modifications of these policies, if applicable, will be posted in the store.
For additional information please dial 1- 800 -MR -START (1 -800- 677 -8278) for the store nearest you.
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
22560
BATTERIES PLUS Purchase Order No.
PO BOX 382 Terms
MENTONE, IN 46539 Due Date 2/23/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/23/2009 7187554 $9.00
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
)VOUCHER 095099 WARRANT .ALLOWED
x22560 IN SUM OF
BATTERIES PLUS
PO BOX 382
MENTONE, IN 46539
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
1
Board members
PO INV ACCT AMOUNT Audit Trail Code
7187554 01- 7202 -06 $9.00
IF S
Voucher Total $9.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
B ttorl+es ius 'e� 1701 F. 4 16•t h St Ct r- Rd. :REG 7Q
Give us your feedback at: (3 .8300
^ti INVOICE NO.
.Ir1
oCfi�{�1�:L GY F'AP:W.2Ef�R H 2QQ9� i'I
ir
L1411 116TH FEC7 'INVOICE DATE
D P
T e1thlE�: X H�`Jl ri T �ii ACCOUNT NO.
0 317-571-2695 Tax Code.- EXEMP E�487275
CLERK( CASH CHARGE CREDIT INSTALLEDADJ WFW RECt)ACC &f PO ttlUNIBER`'a' a,t 'R ,T..gti SHIPVtA
L O :x"'.;• np. J .rM.'Y "er`S 5'4re n. v... -w.5` iff +v9r yx -jai '»e; `m'4'. .C: to "zk` 'S y 't n, w"; R,,;,. 'P-. b
QUANTITY NUMBER sue DESCRIPTION'r�
CORE EACH417EM EXTENSIONS ,7A1('Y /Ns
,..N. _M. a,•.,_•. te..:.,.,� ..n �w.. �xi. .,�.s.ti��,i.,...�s..x..... _,,.f.�...�v.... r...a ��,�.ac..�__w„ a _•....s..�.w..:',.v..
1 1 I *1 C Cpl t* {�1 R I`I �I G`�'Ca L. E 21 71, 99. 7 1. 99. Y
EACH
.1 workman
urcNse
't z' C t� 'U f7 x. t a escription
O. or F
udcet
ine Descr
Ill urcha Date
pay fr�, ppry*!`tis. ?'ry:Fice�Da
h'St J on e s
i z� '�tmy,en TAX <L�
RECEIVED BY THIS.RECEIPT. MUST BE PRESENTED pAyTHIS
FOR RETURNS AND WARRANTIES. AMOUNT 7 1 s 9
We want you to be completely satisfied with your Batteries Plus purchase. In the event you wish to make use of our return or
warranty policy, the following information reflects the policies of our product manufacturers and will help facilitate your return or
warranty.
Return Policy:
Product returns require of purchase or original receipt.
Cash or credit refunds will be given with proof of purchase receipt up to fourteen (14) days from the date of
purchase and apply to merchandise we determine to be unused and in a saleable condition.
A check for refunds of cash purchases of more than $20.00 may be mailed to the customer's home address.
Refunds for purchases made by check require a ten (10) day waiting period.
Refunds for purchases made by credit card will be credited back to the credit card used to make the purchase.
Returns are not applicable to Tech Center rebuilds.
Warranty Policy:
Warranties require a proof of purchase or original receipt.
Product warranty applies to the original purchaser. Warranties are non transferable.
It is Batteries Plus' policy to honor warranty claims within the warranty periods; however,
o Warranty claims will not be accepted. on products that are defective due to owner abuse or neglect.
....,.1 -o Warranty claii ps will not be accepted on products that are defective due to use in applications for which
roducts are not: intended.
m_._
A Warranty claim -may require analysis by Batteries Plus personnel Orior to issuance of credit /replacement.
h
N. hc5 prcrc' 5Wiay'takevip =to tw_,Rtysfvur,
Specific germs and conditions of warranty policy will vary by product type.
°i°u1'odifcatii3iis o7 tries`e policies, if applicable, will he posted in the store.
For additional information please dial 1- 800 -MR- START, 0 800 -677 -8278) for the store nearest you.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
022560 Batteries Plus Terms
P.O. Box 382
Mentone, IN 46539
Invjr Invoice Description
DNumber (o note attached invoice(s) or bill(s)) Amount
211- 188156 Battery for Workman
71.99
Total 71.99
1 hereby certify that the attached invoice(s), or bill( 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.
022560 Batteries Plus Allowed 20
P.O. Box 382
Mentone, IN 46539
In Sum of
71.99
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1125 7- 188156 4237000 71.99 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
26 -Feb 2009
Signature
71.99 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Batteries 1- 007 STORE# 7
BatteriesPlus® L Carmel IN 46032-3 Rd TIME: 0 :13
(317)575-8300
ur feedba
S A L E S I N V O I C F_
*DUPLICATE COPY* INVOICE NO.
SCI•TY OF CARMEL STREET S 7-188185
L #1 CIVIC SQUARE I INVOICE DATE
D P 2/16/09
T CARMEL 4 IN 46032 T ACCOUNT NO.
0 317/571 -2637 Tax Cade.- EXEMP 0 712637
CLERK CASH CHARGE I CREDIT I INSTALLED ADJ WFW REC DACC. P.O: NUMBER SHIP VIA
LD TV IC SQ UARE
QUANTITY NUMBER DESCRIPTION CORE EA ITEM EXT ENSION TAX Y/N
1 0604050 1 2V 900A RESCUE BOOSTR PK 99.99 99.99 Y
Price Unit.- 1 EACH
Savings: from
Jason Force
SUBTOTAL 89.99
S i g n at u r e TAX .00
RECEIVED BY THIS RECEIPT MUST BE PRESENTED
FOR RETURNS AND WARRANTIES. AMOUNT 89° 99
We want you to be completely satisfied with your Batteries Plus purchase. In the event you wish to make use of our return oC
warranty policy, the following information reflects the policies of our product manufacturers and will help facilitate your return or
warranty.
Return Policy:
Product returns require a proof of purchase or original receipt.
Cash or credit refunds will be given with a proof of purchase receipt up to fourteen (14) days from the date of
purchase and apply to merchandise we determine to be unused and in a saleable condition.
A check for refunds of cash purchases of more than $20.00 may be mailed to the customer's home address.
Refunds for purchases made by check require a ten (10) day waiting period.
Refunds for purchases made by credit card will be credited back to the credit card used to make the purchase.
Returns are not applicable to Tech Center rebuilds.
Warranty Policy:
Warranties require a proof of purchase or original receipt.
Product warranty applies to the original purchaser. Warranties are non transferable.
It is Batteries Plus' policy to honor warranty claims within the warranty periods; however,
Warranty claims will not be accepted on products that are defective due to owner abuse or neglect.
Warranty claims will not be accepted on products that are defective due to use in applications for which
products are not intended.
A warranty claim may require product analysis by Batteries Plus personnel prior to issuance of credit /replacement.
This process may take up to twenty -four (24) hours.
Specific terms and conditions of warranty policy will vary by product type.
Modifications of these policies, if applicable, will be posted in the store.
For additional information please dial 1- 800 -MR -START (1.- 800 677 -8278) for the store nearest you.
Bat t e n i e s P l u s 007 S•TORE41 7 o @f� �C�'�S� �C��® a� 1701. E. 116th S Ct r Rd. rte f3# 70
d
a n
Ca rmel, T. Iii li -6032 5 "T' I M o�Zlti la 0.
n:
0 0. o o
R- A L E S I 1\1' :;V G a C.. E INVOICE NO.
QC OF CF1L 4+1E1._. i'i"F2 f °T H °7--1.8(31 Ell :1
L .{tl.' C 1 Y I S G,UARla, I INVOICE DATE
D P �'ii`a 119
T C�A RM E L.,, I N 46',lti 2t; ;v' T ACCOUNT NO.
0 1. 57 1 S3-7 Tax Code% E EMP o `ir
CLERK CASH CHARGE CREDIT INSTALLED ADJ WFW, REC'DACC. P.O. NUMBER SHIP VIA
QUANTITY NUMBER DESCRIPTION CORE EACH ITEM EXTENSION TAXI` /N
1. QC;61714050 E V 900A RESCUE. Bi OSTR P1 99. 99 99.99 y
L
b-It,ZkTia Pay T Y 'D115 ''C-nA.5. l ,'VQ1>r'e :t
SUBTOTAL w rt
c +it'' k1'ra TAX
RECEIVED BY THIS RECEIPT MUST BE PRESENTED D
FOR RETURNS AND WARRANTIES. 89. 9
We want you to be completely satisfied with your Batteries Plus purchase. In the event you wish to make use of our return or
warranty policy, the following information reflects the policies of our product manufac #urers and will help facilitate your return or
warranty.
Return Policy:
Product returns require a proof of purchase or original receipt.
Cash or credit refunds will be given with a proof of purchase receipt up to fourteen 04) days from the date of
purchase and apply to merchandise we determine to be unused and in a saleable condition.
A check for refunds of cash purchases of more than $20.00 may be mailed to the customer's home address.
Refunds for purchases made by check require a ten (10) day waiting period.
Refunds for purchases made by credit card will be credited back to the credit card used to make the purchase.
Returns are not applicable to Tech Center rebuilds.
Warranty Policy:
Warranties require a proof of purchase or original receipt.
Product warranty applies to the original purchaser. Warranties are non transferable.
It is Batteries Plus' policy to honor warranty claims within the warranty periods; however,
o Warranty claims will not be accepted on products that are defective due to owner abuse or neglect.
o Warranty claims will not be accepted on products that are defective due to use in applications for which
products are not intended.
A warranty claim may require product analysis by Batteries Plus personnel prior to issuance of credit /replacement.
This process may take up to twenty -four (24) hours.
Specific terms and conditions of warranty policy will vary by product type.
Modifications of these policies, if applicable, will be posted in the store.
For additional information please dial 1- 800 -MR -START (1 -800- 577 -8278) for the store nearest you.
4PrescribEG't�y State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
Batteries Plus Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Rescue Booster Pk $89.99
Total
1 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 /nA WARRANT NO.
ALLOWED 20
l
Street Center Road IN SUM OF
Carmel IN 460 ,12 3505—
$89.99
ON ACCOUNT OF APPROPRIATION FOR
General Fund
1205 Administration
Board Members
D r INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
89.99 materials or services itemized thereon for
which charge is made were ordered and
received except
n
20
Signat�
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
CEIV ED Bateries Plus 007 STORE# 7
1701 E 116th St Ct JAN 2 3 2009
R�G# 70
N~NN. �0� r
��w���NN�N� r«el, IN 46,013'r.? :3 05 TIME: 03:17
(317>575-8300
[BLI
SALES INVOICE
INVOICE NO-
0 H INVOICE DATE
ACCOUNT NO.
I CLERK CASH [CHARGEICREDIT INSTAL I L I ED ADJ. WFW RECO ACC, P.O. NUMBER �SHIPVIA
QUANTITY NUMBER DESCRIPTION CORE EACH ITEM EXTENSION
A m 8
SUBTOTAL
RECEIVED THIS RECEIPT MUST BE PRE�JENTED' PAY THIS
FOR RETURNS AND WARRANTIES. AMO NT
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
y
�j1 Payee
t
t2r .s t' lk. Purchase Order No.
6" 71 S:t fP Q Terms
G 1 4 2U1,!Q� -�D� 3.50�� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and l have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
9g 9,'
ON ACCOUNT OF APPROPRIATION FOR
6pu fae
1
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
9P 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
1�
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund