HomeMy WebLinkAbout168817 02/12/2009 CITY OF CARMEL, INDIANA VENDOR: 362522 Page 1 of 1
ONE CIVIC SQUARE CECELIA RICE
CARMEL, INDIANA 46032 6938 W 16TH STREET CHECK AMOUNT: $31.16
INDIANAPOLIS IN 46214
CHECK NUMBER: 168817
CHECK DATE: 2/12/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DES
101 2323 31.16 MEDICAL FSA -H INS FUN
Rice
Payroll Elected Deducted Overpaid
1 20.00 4.42 -15.58
2 20.00 35.58 15.58
3 20.00 35.58 15.58
4 20.00 35.58 15-58
80.00 111.16 31.16
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
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
1,A �0 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
115
Total 31
ar,
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
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 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
v2 �Z 20 D
Awl
e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund