176971 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 359506 Page 1 of 1
ONE CIVIC SQUARE V G M FINANCIAL SERVICES CHECK AMOUNT: $790.71
CARMEL, INDIANA 46032 P 0 BOX 78523
MILWAUKEE WI 53278 -0523 CHECK NUMBER: 176971
CHECK DATE: 9/2/2009
DEPA ^T A CCOUNT PO NUMBER INVOICE NU MBER AMOUNT DESCRIPT
1207 4353099 1548831 790.71 OTHER RENTAL LEASES
05235/001 1 1 226 619 0000022213
1111 West San Marnan Drive INVOICE
Waterloo, IA 50701
800 -643 -4354 (phone)
Cflijnanac�i rvi N eces 319 833 -4577 (fax) M money" Invoice Noy Invoice Date PegeNo
1548831 08/14/2009 1
0000022213 AUTO MIXED AADC 350 For customer service contact: 800- 643 -4354
I. 1111111 11111 1 111111 1111111111111111111111111111111 111111111 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
'a a 9 Dli�
c
e a G a k Invoice =Date a ,w w` =Number ��l Dates,,.
4009604 08/14/2009 1548831 09/05/2009
M:b Esras, 3 lak :Y 4 :lE 3
s urrent9: "i' 7 "ast, ue "l 3 Past Due Past Due TotaY
�iontraCt'NO: k YnvOICC Des i tlon.. �a c rrs T 3 4 'rte u
a :.P _.m,» s:Char es 1,.301Da s n 31= 80.:Da s 8:1 +,Da s Due �f
004- 4009604 -001 KENNY- MULTIPRO1250
Payment Due 790 .71 0.00 0.00 0.00 790.71
0
Total $790.71 $0.00 $0.00 $0.00 $790.71
KEEP LI PP. ER PORTIO FOR YOUR REOORI2S
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
U )&N) C t+ f2(J��� �C Purchase Order No.
2 �3Q5 4 Terms
a
&&L Le S 6S:;2 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
i o 79 7/
Total
1 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.
1
ALLOWED 20
IN SUM OF
o S"�2t3
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
99 '790.7 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
20 0
Slnattfro
�tdLl �S[J�i
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund