178904 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 359506 Page 1 of 1
ONE CIVIC SQUARE V G M FINANCIAL SERVICES
o CARMEL, INDIANA 46032 P O BOX 78523 CHECK AMOUNT: $790.71
MILWAUKEE WI 53278 -0523 CHECK NUMBER: 178904
CHECK DATE: 10/28/2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4353099 1624672 790.71 OTHER RENTAL LEASES
251 041 1 287 619 0000021656
1111 West San Marnan Drive INVOICE
Waterloo, IA 50701
800- 643 -4354 (phone)
Financial Services 319 833 -4577 (fax)
"We're more than moniy nvoi
Invoice No:.
"ce`Date F� Page No''
1624672 10/14/2009 1
0000021656 ~AUT0 AADC 350 For customer service contact: 800 -643 -4354
1, 1„ 1,11„ 11,,,,, 1 111111 1111 1111111111 11111111111111111111111 Please call customer service with any address
Attn: PAUL BLOCKOMS changes or questions about your invoice.
BROOKSHIRE FIRST MORTGAGE LLC
12120 BROOKSHIRE PARKWAY
CARMEL, IN 46033 -3314
,Account,Number Invoice Dafe.._ Nurriber, Date.
4009604 10/14/2009 1624672 11/05/2009
Past Due, `Past Due Past Due Total
Contract No` r: Invoice Descri' tion` 6
61+ Da
Ip Char es Ei -30 Da s�. 31 -60 Da i§3"
004 4009604 -001 KENNY- MULTIPR01250
Payment Due 790.71 0.00 0.00 0.00 790.71
Total $790.71 $0.00 $0.00 $0.00 $790.71
ICCCD I IDDCO DnoTlnill rno vni 10 orrnonc
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
J r /,c��,i/� �U /CAS Purchase Order No.
�2 3 Terms
/fi�c 60-L S -1.2 Sa3 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
L
ALLOWED 20
IN SUM OF
US�3
ON ACCOUNT OF APPROPRIATION FOR
Ivy
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
36 9g O 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
rt 20 0
S natur
Titl
Cost distribution ledger classification if
claim paid motor vehicle highway fund