168756 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 360212 Page 1 of 1
0 ONE CIVIC SQUARE MATT WORTHLEY CHECK AMOUNT: $84.00
CARMEL, INDIANA 46032 14383 GEORGE COURT
CARMEL IN 46032 CHECK NUMBER: 168756
CHECK DATE: 2/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4460848 50.00 4TH GATEWAY /RANGELINE
902 4340600 2009002241 24.00 RECORDING FEES
902 4460848 2009002241 10.00 4TH GATEWAY /RANGELINE
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
O r- iL I 2 V Purchase Order No.
eeo j e Cm 4' 4- Terms
I Al N Q 32 Date Due
Invoice Invoice Description," Amount
Date Number (or note attached invoice(s) or bill(s))
00
1 9 o
I?eC* 006 48 m 41 r ps re s-p o0
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
IN SUM OF
gt aO3Z!
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
qD 17 �q �/U� °8g to bill(s) is (are) true and correct and that the r
10 /V/V I �OY So °O materials or services itemized thereon for
which charge is made were ordered and
received except
20
1
Signat re'
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i
Prescribed•by State Board of Accounts I 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
A6 f� l� r Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0 //O'� 2 rld 2') 0 Z Z 00
Total 2
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
r Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF$
F
f
ON ACCOUNT OF APPROPRIATION FOR
Board Membe s
i
PO# of INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
q0� �ooioG22y� `�3�0�00 2 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
20O
Signature
Cost distribution ledger classification if T e
claim paid motor vehicle highway fund