HomeMy WebLinkAbout168136 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 362451 Page 1 of 1
ONE CIVIC SQUARE OLD NATIONAL BANK CHECK AMOUNT: $100.00
V PO BOX 80159 CARMEL, INDIANA 46032
INDIANAPOLIS IN 46280 -0159 CHECK NUMBER: 168136
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1301, 43.47500 408094 100.00 GENERAL INSURANCE
s
I
Effective Date Policy`Period C o v e r a g e D e s c r i p t i on Transaction Amount
01/,01/09 01/01/09 Fid Dep Cc of Maryland
to Policy No. 30452246
01 /01 /10 Renewal Miscellaneous Bond 100.00
Invoice Number: 408094 Amount Due: 100.00
*Premiums Due and Payable on Effective Date
IJMCK Page: 1 ORIGINAL INVOICE
For questions about your bill, call 317.575.9999 oldnationalins.com
INS -1
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
ti 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.
y Payee
.J/ ink Purchase Order No.
f d t�1 D /l q Terms
460 0 01 1 1 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02 08 4 fQ8vg�
4100.0
Total 00 .0
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.
ALLOWED 20
IN SUM OF
G a�o -o ls9
10 00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
P Or INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
g-p biil(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
1
J A tL 200
--Sin ure
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund