178511 10/26/2009 M CITY OF CARMEL, INDIANA VENDOR: 360613 Page 1 of 1
ONE CIVIC SQUARE BOBBY JOHN LLC CHECK AMOUNT: $7,125.00
CARMEL, INDIANA 46032 9589 VALPARAISO CT
INDIANAPOLIS IN 46268 CHECK NUMBER: 178511
CHECK DATE: 10/26/2009
DEPARTMENT ACCOUNT PO NUMBER IN NUMBER AMO UNT DESCRIPTION
902 4460814 101609 7,125.00 STREET DEPT FACILITY
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r, BOBBYJOHN, LLC
9589 Valparaiso Court
Indianapolis, IN 46268
317 870 -9900
Date: October 16, 2009
Property: 457 Third Avenue SW, Carmel, IN
City of Carmel
One Civic Square
Carmel, IN 46032
RE: 457 Third Avenue SW, Carmel, IN
MAKE CHECKS /MONEY ORDERS PAYABLE TO: BobbyJohn, LLC
Amount Amount
Date Description Amount Paid Due
11/1/2009 Rent Nov 1 Nov 30, 2009 7,125.00 7,125.00
Balance Due
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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.
Payee
LLG Purchase Order No.
�cv, Terms
�62�6� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
v
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.
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ALLOWED 20
IN SUM OF
9 11 Co 17
7, 2 5
ON ACCOUNT OF APPROPRIATION FOR
9a d ,F/y
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
G2 10 /5 Gg �y (a G.?ly 7 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
Q-LA94%)
Signatur
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Cost distribution ledger classification if
claim paid motor vehicle highway fund