206881 02/29/2012 a CITY OF CARMEL, INDIANA VENDOR: T0002723 Page 1 of 1
ONE CIVIC SQUARE DREES PREMIER HOMES CHECK AMOUNT: $331.91
CARMEL, INDIANA 46032 PO BOX 745
LAFAYETTEIN 47902
CHECK NUMBER: 206881
CHECK DATE: 2/29/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 331.91 REFUND
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
To -,r G
ADDRESS Ig ,,RW a T y e e V 4 -W
Invoice Date Invoice Number Item Amount
y2- 3 zS z2
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
Mo. Day Yr. Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (are) tZZT nd I have audited same in accordance
with IC 5- 11- 10 -1.6.
Mo. Day Yr. Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
CARMEL, INDIANA
Favor Of
�a e #e 7W �c 7 90 L
Total Amount of Voucher
Deductions
Amount of Warrant 3 9�
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
ROYCE FORMS SYSTEMS 1- 800 382 -8702 325