179341 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 00350093 Page 1 of 1
ONE CIVIC SQUARE NEARLY FAMOUS INC CHECK AMOUNT: $750.50
CARMEL, INDIANA 46032 11656 POMANO DR
INDIANAPOLIS IN 46236 CHECK NUMBER: 179341
CHECK DATE: 11/11/2009
a EPARTMENT ACCOUNT P O NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
651 5023990 3163 750.50 OTHER EXPENSES
INVOICE
DATE: 0 G
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9801 Fall Creek Rd. #145 l TERMS: S Da
Indianapolis, IN. 46256
(317) 459 -9693
CUSTOMER P.O.# 0 Vi is
DEPT:
Cc� nearlyfamousl@yahoo.com
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SHIP VIA: &O" y F.O.B.: I_ SALESMAN: Pc I
SHIPPED STYL DESCRIPTIO Unit /Price TOTAL
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DATE: I a 0
TERMS: P 15
9801 Fall Creek Rd. #145
a
Indianapolis, IN. 46256
CUSTOMER P.O.# U
(317) 459 -9693 DEPT:
nearlyfamousl@yahoo.com
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SHIP VIA: ���Y F.O.B.: SALESMAN: �aw
SHIPPED STYLE 'j DESCRIPTI N Unit /Price TOTAL
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Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER F
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
00350093
NEARLY FAMOUS Purchase Order No.
11656 POMPANO DR Terms
INDPLS, IN 46236 Due Date 11/2/2009
Invoice Invoice' Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/2/2009 3163 $750.50
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 55- 11- 10 -1.6
Date Officer
i
yi
VOUCHER 096644 WARRANT ALLOWED
60350093 IN SUM OF
NEARLY FAMOUS
INDPLS, IN 46236
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
3163 01- 7200 -01 $750.50
z� a
Voucher Total $750.50
Cost distribution ledger classification if
claim paid under vehicle highway fund