179761 11/24/2009 CITY OF CARREL, INDIANA VENDOR: 358695 Page 1 of 1
ONE CIVIC SQUARE SUZANNE MAKI CHECK AMOUNT: $187.39
CARMEL, INDIANA 46032 1300 HELFORD LANE
ap CARMEL IN 46032 CHECK NUMBER: 179761
CHECK DATE: 1112412009
DEPARTMENT ACCOUNT P N UMBER I NUMBER AMOUNT DESCRIPTION
1160 4343004 15.73 TRAVEL PER DIEMS
1160 4355100 171.66 PROMOTIONAL FUNDS
l�.r-+e� -�z�� �c�r �v�r�,� 51-�-� n n I
LA M I E E M 1! 7
Date 55 PM
Chpr,,
a
7F
Approval: 0
RETAIN THIS COP! FOR YOUR RECORDS
L-1355100
O,F
-e�
1 D12-91c)
MARSH CAFE
2140 E. 116TH STREET
CARMEL, IN 46032
(317)575-3650
8-159 CHOC 1-HNK Cf, 11, J K I li.
8962 BR I CO SGR COOK p
'2 BR ICU SGR COOKI .29-F
[Ax 00 k il
CASH
C Fl A 14 G;
N li m B E R O .1 1 F
09 1 2 20 1 O 9 3G 01 1 2 -1 1
YOU SAVED
.29 1%
ON YOUR ORDER TODAY
fllf)NK YOU FOR SHOPPING N m;;r;,jj
YOUR f-A)SHILP, WAS KAI
'YOUR SAVINGS
FRESH IDEA SAVINGS .29
TOTAL SAVINGS
(4%) .29
YOUR SAVTWrC
C U s ti m r
L F I
35 S 1 CID
a y
i AA4 11 q
/SaC)
1 vJ a- e s r F5 Wo i K =t- r 1,, i V'
The Pharmacy 60 Trusts \Since 1901"
I'm Peter, Thank you for allowin me
to serve you toda
218 10 3195 0323' 003
RFN# 0323 -103;3 -1953 0910 -3020
CNDY MTR B4 1A 1.99
CNDY MTR BRG lA 1.99
JDY MTR BAG 1 A 1 .99 -VOID
JDY MTR BAG lA 1 '91,1 SALE
)'AM S14JTR16,901 -15S 3 gy
TOTAL
CASH 20,00,
CHANGE 16.0'
��i I II ►11111111 i1IIII II IIII I IIIIII I I It I III I I IIIIII I IIII I IIII1 II111111II
1 1215 S Ran gge Line Rd Carmel, IN
STORE (K)571-11 ?6
OPEN 24 HOURS
THANK YOU
H1N1 VACCINE AT SELECT WALGREENS
F OR VVISIT ,WALGREE�NS- COM /F
LU
CAN'T F::ND I'f IIJ THE STORE?
VIALGREENS COM HAS THOUSANDS OF
ITEMS ONLINE
SAVE ON YOUR PRESCRIPTIONS BY JOIN' �0F4
WALGREENS PRESCRIPTION SAVINGS r
SEE PHARMACY 1 =0R DETAILF
OCTnRFR A0. 2009 s
0 o �d� Z 1 Qr cP
Ica e v
r0
T ro m o4� Oy f s
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
11/23/09 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
Sue Maki Purchase Order No.
1300 Helford Lane Terms
Carmel IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10 30 0 Recei t Refreshments for visitors 3.99
10 28 0 Receipt Refreshments for visitors $6.49
10 30 0 Receipt Lunch for visitors $161.18
Total $171.66
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.
,11 /2 /ag ALLOWED 20
Sue Maki IN SUM OF
1300 Helford Lane
Carmel IN 46032
171.66
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4355100
Promotional funds
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Receip 4355100 $3.99 bill(s) is (are) true and correct and that the
Receip 4355100 $6.49 materials or services itemized thereon for
Recei t 4355100 $161.18 which charge is made were ordered and
received except
1 4 1 X-3 200
at
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
heetalbed by State BoWd of Accounts. ral Form No. 101 (1951
Co, r� e MILEAGE CLAIM
Cam` Zap n n I
(GOVERNMENTAL U NIT) U, TO DR.
ON ACCOUNT OF APPROPRIATION N0. FO
(OFFICE. BOARD. DEPARTMENT OR INS ITUTION)
SPEEDOMETER AUTO MI
DP FROM TO READING+
DD NATURE OF BUSINESS P MILES
I,g> TRAVELED g v �E
POINT POINT START FINISH
f, I Vl rt v 1R r
Yn i V1 r'i G
i
l
AUTO LICENSE NO. TOTALS
+SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155. Acts 1953. I hereby certify that the foregoing account is just and correct. that the amount cl ed is legally due, after allowing all just credit: m
and that no part of the sae has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form
That it is duly authenticated as required
by law.
That it is based upon statutory authority.
That it is apparently correct
incorrect
/s, 7 ,3
On Account of Appropriation No for
is ursing Officer
CO
Q a, n
o Q CD
Allow 19 Ca a
o
in the sum of 'n o A
(D CD
Z g
C.0 (D
Q CA y
a
CD 5: 5 om
(D
(Board or Commission) k Q
'D a
Q o 0
FILED m a CD
TjM
M
CD A
5'•
y m
(Official Title) Ei. fD
n a�
0 A (D a w
m
1 A.C. ROYCE CO.. MUNCIE. IND. 0817] (D
rD a