175251 07/28/2009 ;qs CITY OF CARMEL, INDIANA VENDOR: 363009 Page 1 of 1
ONE CIVIC SQUARE NATALIE PILTZ BRAKE
,?o CARMEL, INDIANA 46032 6441 PARKLAND PLACE CHECK AMOUNT: $100.00
INDIANAPOLIS IN 46256 CHECK NUMBER: 175251
r CHECK DATE: 7/2612009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO UNT DESCRIPTION
10.1 5023990 100.00 REISSUE CTS 173999
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File. Edit Held 1) 7� ffi
FUND 10T GENERAL FUND. Year 200
SUB- DEPARTMENT 1 01: GENERAL FUND Period 6
count 5�239 v 90 -j OTHER EXPENSES Transaction Code r21 Accounts Payable Check
Sk Transaction Date {0612 _i
TASK ACCT Date Entered 10612412009
r Cash Account 1101 CASH Due Date 4/
Vendor 363009 NATALIE PILTZ Invoice Date
Discount Amount
Receivable Account
Disbursement Fund 101 GENERAL FUND Check Number: 173999
i
ENCUMBRANCE Check Date 06124/2
J E Number. PartiallFinal
InvoicelReceipt`, 10991 N No 7 099
u�
,Amount 100: Cleared
Sales /Use �T ax 0 00 Void
I Descnpton JOTHER EXPENSES' Control Number 1
I Entered'By csheeks 0ank�Code
i Warrant Number
Back(ct-1 +P)
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.
AL Payee
A
m5 LL-/ i, A f7— Purchase Order No.
9I 7 a_, CA Cif p4
Terms
n� �I s ten/ V1 Z:)
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
ttj d n e P 1p
Total /ek_o
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.
a ALLOWED 20
fz' IN SUM OF
7 7-- r.b re) a k ,t. 4,o-1 b
160
ON ACCOUNT OF APPROPRIATION FOR
Board Members
D PT INVOICE NO. ACCT /TITLE AMOUNT 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund