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179243 11/11/2009 "e. CITY OF CARMEL, INDIANA VENDOR: 129401 Page 1 of 1 ONE CIVIC SQUARE MICHAEL HOLLIBAUGH CHECK AMOUNT: $11.99 CARMEL, INDIANA 46032 CARMEL IN 46032 CHECK NUMBER: 179243 CHECK DATE: 11111/2009 D EPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION 1192 4355100 11.99 PROMOTIONAL FUNDS Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) P 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/04/09 Coffee for meetings $11.99 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 VOUCHF,,R NO_ WARRANT NO. ALLOWED 20 Michael Hollibaugh IN SUM OF c/o One Civic Square Carmel, IN 46032 $11.99 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1192 43- 551.00 $11.99 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 Monday, November 09, 2009 irector OCS Ti Cost distribution ledger classification if claim paid motor vehicle highway fund