206325 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 366040 Page 1 of 1
ONE CIVIC SQUARE KUMMAR KHANNA
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+a CARMEL, INDIANA 46032 12195 N/INDPOINTE PASS CHECK AMOUNT: $75.00
CARMEL IN 46033 CHECK NUMBER: 206325
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 MAILBOX REPA 75.00 REPAIR PARTS
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VENDOR: 366040 Page 1 of 1
CITY OF CARMEL, INDIANA KUMMAR KHANNA
w CHECK AMOUNT: $75.00
ONE CIVIC SQUARE
c 12195 WINDPOINTE PASS CHECK NUMBER: 206325
CARMEL, INDIANA 46032 CARMEL IN 46033
CHECK DATE: 2/1412012
AMOUNT DESCRIPTION
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER 75.00 REPAIR PARTS
2201 4237000 MAILBOX REPA
Name
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VOUCHER NO. WARRA NO.
ALLOWED 20
Kummar Khanna
IN SUM OF
12195 Windpointe Pass
Carmel, IN 46033
$75.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 42- 370.00 $75.00 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
We'dnesday;' February 08, 2012
A/ r
�y'rR
Street Commissioner 'f
n a._
v vv Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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 service rendered, by
who. 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))
02/02/12 $75.00
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