173656 06/16/2009 CITY OF CARMEL, INDIANA VENDOR: 360212 Page 1 of 1
ONE CIVIC SQUARE MATT WORTHLEY
CARMEL, INDIANA 46032 14383 GEORGE COURT CHECK AMOUNT: $29.68
CARMEL IN 46032 CHECK NUMBER: 173656
o
CHECK DATE: 6/16/2009
DEPA RTMEN T ACCOUNT PO NUMBER INVOIC NU MBER AM OUNT DESCRI
902 4239099 6.68 OTHER MISCELLANOUS
902 4460847 23.00 HEARTHVIEW OLD TOWN.
9rescribed Cy State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
28 <J9 52Yo9
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.
ALLOWED 20
�/o -�jlPy IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
90 -3 01
Board Members
PO# or DEPT. INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
00 52 09 'k5,9e bill(s) is (are) true and correct and that the
l materials or services itemized thereon for
which charge is made were ordered and
received except
6 -17 20
Ignature
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Slate 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
M Wo Ll ey Purchase Order No.
5 7 S- �/�.e� N G� Terms
Q Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
V1 5/ D 9 `f'1 R r o o� try 2 3. °a
Total 2 3 0 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.
l
ALLOWED 20
IN SUM OF
s 7 f S ".-f N
2 3
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
9 a2 5 o g 060 9 47 1- 2 3 °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
`"/7 20
Signature
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund