173931 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 195575 Page 1 of 1
ONE CIVIC SQUARE MARTIN MARIETTA AGGREGATES
s{ CARMEL, INDIANA 46032 PO BOX 93186 CHECK AMOUNT: $554.24
CHIGAGO IL 60673 -3186 CHECK NUMBER: 173931
CHECK DATE: 6/24/2009
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4350400 7711578 303.04 GROUNDS MAINTENANCE
1205 4350400 7711932 173.25 GROUNDS MAINTENANCE
2201 4236100 7752619 77.95 SAND
Martin Marietta Materials Page 1 of 1
V
P.O. Box 30013 FOR BILLING QUESTIONS PLEASE CALL
Raleigh, NC 27622 -0013 31 -7 573;4460
Visit eRock rm at www.martinmarietia.com
JOB NAME: MISC JOB TAXABLE TRK
SHIP TO:
SOLD TO: 00487 00747 MISCELLANEOUS JOB TAXABLE TRUCK
CITY OF CARMEL- STREET DEPARTME 131ST SHELBORNE
3400 W 131ST STREET Indianapolis IN 46240
WESTFIELD IN 46074
PAYMENT TERMS: NET 30 DAYS AIR
Order No. Customer PO Dest Job No. Dist Business Business Unit Name Cust. No. Invoice Invoice No.
No. No. I Unit I Date
5164662 SO 005 1 888801 11 25103 1 Carmel Sand 231877 06108/09 7752619
Ship Date Product Description Quantity UM Unit Price Material Freight Freight Taxes TOTAL
Car /bar a No. No. Amount Rate Amount Fees
06101/09 0974 FAS MASON S
17463 3.36 TN 23.20 77.95 77.95
*SUBTOTAL* 3.36 77.95 77.95
TOTAL 3.36 77.95 77.95
�INVOICE.TOTAL ',$77:95.=
DETACH and Include this Return Portion with Payment
Martin Marietta Materials ^A
REMIT TO
CUSTOMER NUMBER: 231877 CARMEL CITY OF STREE MARTIN MARIETTA MATERIALS
PO Box 93186
INVOICE NUMBER: 7752619 Chicago IL 60673 -3186
PAYMENT DUE $77.95
Please report any potential ethics violations to the Martin Marietta Materials Corporate Ethics Office 1- 800 209 -4508 or see www.martinmarietta.com.
For all other questions call the number above.
PLEASE NOTIFY. US OF ANY ALTERATIONS YOU MAKE: TOWARDS- THE'INVOICE AMOUNT'.
Prescribed by State Board of Accounts City Form No. 261 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized most 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
r
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/08/09 7752619 $77.95
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. WARR NO.
ALLOWED 20
Martin Marietta Materials
IN SUM OF
P. O. Box 93186
Chicago, IL 60673 -3186
$77.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member!
2201 7752619 42- 361.00 $77.95 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
f Thursday ,Junk 18, 00f
tre Commissi'�orier
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Martin Marietta Materials WARNING
See important health information on reverse. COPY COPY PRECAUCION t��
�R Ver information importance pars la satud en el reverses
Visit eRocksTm at www.martinmarietta.com Ticket##: 416607
'I 231877 Job# 888801 002 25103 Carmel Sand
Sold To: Sold From: mz
CARMEL CITY OF— STREET DEPARTMENT 7:30 -4:00 MONDAY FRIDAY V
3400 W 131ST STREET CLOSED SATURDAY SUNDAY D9
WESTFIELD IN 46074 #317- 846 -8540
PO No: Job Dest. Information
Date:05/19/09 Time:10.
Hauler: Truck: COC MISC JOB TAXABLE TRK o
Haul Rate MISCELLANEOUS JOB TAXABLE TRUCK 3
CITY HALL e
Lot#
1; 0,11
Today To Date Lbs Tons Cash Sale
49°000 24.50
Job: Lds Quantity Quantity Gross: Matl
1 11.00 16.29 Man Wt.
Dest: 1 11.00 11.00 Tare: 27.000 13.50 Tax IN
Product Number: 0807 Net: Man Wt. Haul$
Payment Recvd By:
Description: n0. 8 22,000 11.00 Total$
Sec. Prod 0.00 QTY: 11.00 Ton Max GVW: 80°000.00
Additionallnformation: Weighperson: KRISS
A C Q# 982083 SOURCE# 2303
C, hill
Driver` Customer: 2341
Martin Marietta Materials Standard Terms and Conditions apply (copy available at Site Office). CONTROL NUMBER
A
i
Pursuant to prior oral or written agreement between the parties. delivery occurred and title passed immediately after the products were loaded into the carrier at the
point of shipment. All hauling from this plant or quarry at an agreed rate per ton or yard is performed by independent trucking contractors. Drivers, other than owner-
drivers, will be employed by the trucking contractor. The tntcking contractor assumes all liability for compensation, public liability, and property damage insurance, also
all social security taxes, withholding taxes, and any other taxes assessed.
Aggregates may contain components that could react with alkaline materials in concrete mixtures. This could result in potential deterioration of and damage to the
final concrete product "Alkali- Aggregate Reactivity" or "AAR The potential for AAR should be taken into account in formulating concrete mixtures. Other than
warranty of title and conformance to written specifications, MARTIN MARIETTA HEREBY EXCLUDES ANY AND ALL WARRANTIES OF M ERCHANT-
ABILITY AND ALL WARRANTIES OF FITNESS FOR ANY PARTICULAR PURPOSE AND ALL WARRANTIES, EXPRESS OR IMPLIED. AS TO
THE PERFORMANCE. OF ITS AGGREGATES WITH RESPECT TO AAR.
This is to certify that the following described conunodity was weighed, measured, or counted by a weighttmster, whose signature is on this certificate, who is a recog-
nized authority of accuracy, as prescribed by chapter 7 (commencing with Section 12700) of Division 5 of the California Business and Professions Code, administered
by the Division of Measurement Standards of the California Department of Food and Agriculture.
'R•Q -1
This product contains crystalline silica. Prolonged and repeated breathing of crystalline silica dust can cause a progressive lung disease called silicosis. t F
Several scientific organizations have reported that prolonged and repeated breathing of crystalline silica dust can cause lung cancer.
Crystalline silica is known to the State of California to cause lung cancer.
Silicosis or lung cancer can result in permanent injury or death.
To reduce the risk of injury, prevent excessive and repeated dust exposure or use a NIOSH approved respirator as more fully described in the MSDS.
The risk of silicosis or lung cancer depends upon the duration and levels of silica exposure.
Read the Material Safety Data Sheet before using or handling this product to detemtine the appropriate ventilation or respiratory protection necessary to
safeguard your health. MSDS are available on our website at www.martinmarietta.cont or ask the plant manager for a copy.
Este producto contiene silice cristalina. Respirar el polvo de la silice cristalina repetidunrente y por periodos prolongados poetic causar In silicosis, mm enfennedad
progresiva de los pulmones.
Varias organizaciones cientificas reportan que el respirtr el polvo de la silice cristalina de forma repetida y per periodos prolongados puede causar ctincer del
polntdn.
El Estado de California reconoce que In silice cristalina cnusar crancer.
La silicosis o cl cancer de pulm6n pueden causar dalos permancntes o la muerte.
Pam reducir el riesgo de sufrir danos a la salud, evite repetidamente y per periodos prolongados que es'te expuesto A polvo do In silice cristalina o usar tin
respirador aprobado del NIOSIi.
El riesgo de In silicosis o del career pulmonar depende de la duracidn y de los niveles de exposici6n a In silice.
L6ase la floja de Datos subre to Seguridad de his Materiales (Ilamada "Material Safety Data Sheet antes de user o manejar este productopura Jr 4
determinar la ventilati6n apropiada o la protecei6n respiratorin necessrio para pruteger so salud. La Hoja de Datos sobre Ia Seguridad de los Matt ria lcs esia
c disponible en nuestra sitio web wwiv.martinnrarietm.com o le puede pedir una copia so gerente de planta.
r
M artin 6' �Wr�etta at�i ���lS �W WARNING �6
See I mpOrldnt health info uo on rave 3 '0 3
t. v COPY PRECAUCION
to Pa 3.�
Ver nformacion imDodanra la ia en el a erso
I Visit eRocksTm at www.martinmarietta.com T,, -.k,;i A07RI A& ,w
Sold To: ;1 R77 .lnl,# RRRRO 01)1 Sold From: i f! Nnrf F� TnA i an nnl s.� z W
r r.ARwi r. TTY' ng— c;TRFFT I)FRARTMFNT 47(1 1 Fasf 9f,f,h ,_�f rapt No
r X400 fat 1AIRT RTP FT 17f R4f, —f,i�t '�o
Ir1FRTFTFl n Thl 4e4074
Date: Time: PO No: Job Dest. Information
OF, /IRA)q Truck:09s74 �s
Hauler: 17AFiR1Fl 705 1'ARIWFI f;T f1FPT my-,r .Tf1R ..Tc1X F7(FMPT TftK C
t� WahlF7atc= PAT 1;M I.ANFniit; anR' FRFIwPT TRIIrt( tit
Tflwm WAI f
f nt4
Today To Date. Cash Sale
Lds Quantity Quantity E Tnn
Job: Gross; 4R 9AA 94.4R
Matt
1 1.1 i49 11-4q (1
Dest: 1 11-49 .1 i 4q Tare: 9 9R0 1?-99 Tax T N
Product Number: 0A X7 Net:
Payment Recvd
Haul$
Description:. TN- Nn- Rr: 9? 9110' 11.49 otal$
T
X71• it Snr PrnA n On f3 V s
11 .'49 Tart Mwx l;tJW s '`i9 666 flfl jj��•
I F [8
Additional Information: Weigllperson:
VATHY
TpjnnT Rf11IRr:F '7111 1191190 1
Iii -F 72 60- 60:. qAT ri ,n ,FT1
x Driver: Customer: 015 s
Martin Marietta Materials Standard Terms and Conditions apply (copy available at. Site Office). CONTROL. NUMBER`.
Put snant to prior oral or written agreement hum, cn the parties, delivery occoned•and title passed itninediately alter the products were Witted into the enmer at the
point orshipment. All hoofing I•rorn us plant or quarry at in agreed mw per ton or yard is performed by inrl epcnttcrtf1ruckingcyn trackrt5 Drivers, other than owner
drivers, will be employed bylhe tnrcking contmc,tor.,Thc trucking rnutractor assumes ail liahiloy Ibrcoanpcniation, public liabitity. and propcny damage insurance. also
ill social SOCUrity Lrites, withholding Lases, and ary titer tip c as u
\ggre gaies may curtain components that'could react with alkaltie maIeriaIs in concrete misinres. This could result in pot nun I deterioration oraad damage to the r
final concrete prodnoL ('A lkah -A ggredme Rcactrnty or "a \AR 1. 1'hc phluttiul for AAR slund<I be taken into accat in iornutlahng t:oncrctc tuisnrrci. Other than
veamamy of tide and conformance to written specifications. MARTIN NIA RIE "FlAHER FRY EXCLUDES ANY AND ALL \4'ARRANFf ES OF p'II'.R,CH ANT-
A131L1 '1'1'AND.41.3,HS \RRAN'IIFS OF FITNLSS I'ORANI' B4RTICIJLAIt 1'IJR.POS ,AND ALL WARRANT IFS. E PRESS ()R ID1PLI ED, AS 1 0
THE YERFORNIANCE OF ]T$ A((RkC.V1' S wl FH RI 11 FCTTO AAR.
e This is to certify that the fe Llowm4 desu ibcd u. umodity w t weighed. measured, or counted by a weighmast r wicase si}.namte is on J, Curt il cal 0. who is a recog-
t nized authority of accuracy as pteccnbcd by chaplet 7 (conmencmg, i(h Section 12700) pf Division of the Cahkniva Business and-Prt t issions Code, administered 9i-1h
by the Division of Mcosu, cmcnL SLandurd, ufthe Cah(omta Department of Food and .1grcuhtuc. try
uuU���
This product contains crystalline iHun. Prolonged and repe,ded breathine of crysod me silica dust can causes pMg'ressive hmg disease c,,Ued it icosis.
Several scientific organimnions have repr rted that ptodonged and repeated breathing or crystalline silica dust can cause Inng cancer.
Crystalline. silica is known to the State of California to cause lung cancer.
Silicosis of luny, cancer can result in permanent injury it death.
To reduce the risk of mluryt proem excrssivc and repented dust exposure or use a�h'1Qti] -I approved respirator as more futly described in the MSDS.
The risk of silicosis or hmg cancer depends upon the durauon and levels of silica csposum.
Read the Material Safely Data Sheet before using ar handling this product Lo determine the appropriale ventilation or respirnory praleclion necessary to
ssa regnant your health. NISDS nre available on w w %eb a 3t www maturimatietta com .nr ask flio plant mi mabct find opy
Fs }z producto conticue sflice ciistahna. RosphaCel pod— de la silice cristalina repetidamente y par periodnS pcolongados puede causar la silicosis, mm enfennedad
ptngrestva de tos polotmes.
Vanas organizamones c enttficay. reportan que el respirar el. polvo de In silice cristalina de'forma repetida y pot periodos prolonbados puede causar cLincer del
Lt Estado de Cali Mortar reconcce clue ]a silice cristaIin e causar ciincer.
LN
La silicosis o el ctincer de pulm6n pucden causar chroos permanentest o In nuterLc.
1 Para reducir el riesgo de sufrir dadas it la salud, evne repetidamente y nor periodos, prolongs dos que este capueslo al polvo de In silice cristalina o user tin
t espnador,probadc, del N1OS11.
El dcsgo de to sihcosis o del cancer pulmonar dcpcnde do la dnrauan s de Ids nw @7 s.de expusici6n a to silice
-I.6ase In.Hoja do Datossn111'e [a$egwridad de Ins Nateriales (liamnds ";,Material Safety Data SheeC') antes do usar o manejar estc product n para
delerminar Is vent itachin upropiada o la proleccirm respiraturia necesarin pnra prolcgcrso salad. La Hoja do Dates sobrc lu Sogmidad sly los Materiales csta
disponible eh nucstro sitio web Wwiy.mtariirragrieiw cam m to puede petlir una copin su gerente de planla_
Itz
Martin Marietta Materials p�
waRktNG
COPY Sae important hea3lh inl6rrnavon 6n r evrw •1W
V.r Vbn pananta Para la salad en 6 reverso
Visit eRocksTm at www.martinmarietta.com w i7 q h w
77 R77 .7nh# RPRRti7 fif i tt7r 11UtnF #Sy. TntlTareanni i
Sold To: Sold From. i N�
r'ARMIrl r:TTY r1F- RTRFFT I)FPARTHI =NT 47tZC1. F t 9/.th tP.G+c�4
�m
U00 14 i 31 RT gTRFFT 117 i 46—A i "L 1
WFRTFT;'l T) 7N 4AO74 w
Date: Time: PO No: Job Dest. Information
(i!SJ14lt14 Truck: 17.54 �u
Hauler: rARNFI '209 RARMFI RT nFPT MTRI' mn -TAY FkFK"PT. TRK •Ax
iT141!' HAitIRatP- MTRrFll l ANFI111c; inR :F?[FIAPT TRl irk
Trim HAI
I nt84
Today To Date 1 h� Tnna .Cash Sale
Lds Quantity Quantity
Job: Gross: 4R 4130 94'- 74
Matt
1 10. AA •77. 17 r 1
Dest: Tare:
1 1 t7 Al 77. 17 77 7 ?0 II A A 1 T h1
Product Number: 0AA7 Net:. 1 Y
f Haul
Payment Pecvd ey
Description: TAI_ Nfi_ y Rr ?i .9t,� i �4fi." Total$
Rf+r PPnri n_ on PT 1 0 ok Tnn MAW r vw i7 606
Additional Information: Weighperson KATHY
TN1)nT sni tRr'F �i i i.,- CJ4A?01 tl
7: 60 4 i 06 q4T rl rl.q
l' Driver: Customer: 2 6 �J 6,
Martin Marietta: Materials Standard Terms and Conditions apply (copy available, at -Site Office).' CONTROL NUMBER
Ni suamtoprtor oral or'riuen agreement bet wee nIhe parties, dalivcrvoceurIvd all dIiIlepacsed immediately an the produ,is ,verclorded inloihecanieiatthe
point of shipment "Allhnul ing front this plant orquarry at art agreed vile.per tqn or yiird is perrormed by independent irieking Qoutrwior5. Dri it N, other than owner-
drivers, will bc'empI(,Vcd by the trucking contractor. Tbc irk :king catuicror ussumcs rylt liability for compensntioo, pull Iic I a bruin•, and property. (in III agc insurance, also
all social security taxes. svithlb6lding'taxes', and any nlher I1X( rssiesad
Aggregates may contain components that could react with alkaline material., in concrete mixtures This could rcauh in par nt ail dcieri t area pf and damage to the
final concrelc product I Alkah- Aggregate Reactivity' or''AAR" The potential for AAR should be lakcn into Iecount in frmtulnting Other than
w amfonnaticc touritten sliecifications, MARIETTA HEREBY Exa.UPES A NY AN D A I J. WARRA"TIES OF NI E.RCHAN
ABILITYANDALL WARRANTIES OF FITNESS FOR AN YPARTICUL,M P URPOSE AND A 1.1, WARRANTIES, EXPRESS OR IN I PLIED, ASTO.
THE PERFORr•LANGI OE ITi �((RECA'k'GS'N'1'1'll RFCI I :CT'I'OAAR.
This is to cerbifv ihat the followin described eontuuiduy tt i oc ghgd, measured, or counted by a wciefimasi 1, whose sigonitu is ctrl this ntf catc, who is a rccog-
nixed authority of accuracy, as Prescribed by chapt-r 7 (conimencmd with Section 12700) of Division of the C iltlomia Fusincss and Professions C,`odc, administered'
}'J by the Division of Measwiment Standards.d'the Calif mIla .[Food and Agriculture.
O R D D
P` e
This product contailis crystalline sili Prolonged and repeated breathing ot'crystulline silica dust can cause a progressNe lung disease callctl silicosis.
Several scicntitic organizations have reported that prolgngecl nll(t repeated bFC, orerg'sialline silica (I t t .rd cause lung cancer,
Crys silica is kntown to die Statc of Californra to cnttac hntg cancer.
Sihciisis or hung cancer can ir kilt in permanent injury or death t
To reduce the ❑sk of uqury, prevept cxce ne :tnd a'epeatcd dust ex3?osure orrusc n'Nl(.)SH approvetf respirator as nixie fully descrihed in ih'e M$DS.
r
Th. rdofsincosis or lung. cancerdcpendsupontheduration and le vels 61, silicti .r'Jtosurc.
Read the Milterial Safety' Data Sheet before using or handling this product Id determine the ap(anprate vcnti'l vion or rvspirutory potwGnn necessary to
..f g,lard your health MSIDS arc available on our webvtc m tvu•ss nlauinnmri na aom or sk die platy m, n it fpr a copy
'0 0 D °00 O e
Taste p1'pduCto—miene crislallna. Respirai'el polvo tic la silicGCCl tits llta'YfpCli(IaYI)CttIC ypor periodos prolong.tdi±s pnCdC Ca115ar la SdICosis, unit enfonvedrd
progresiva de los pulmones.
Vanes or6auizacionea cicnuhcaa repotteh quc el respixar el polni de is silicc enstalinu do form'1 tepeti�a g' per 1.tcrivdos- prolnng5drss pueile eau Ir ceSncei del
put bur
El Estadv'de C tlihimia reconoce clue la stlice iristalina catfsar cfincer. r
fan sthcosis o el cincu do pulm6n pneden causar dw)os perman iii s o In inuere.
Para reducir el riesgo de sufrir dafioa a In salad, evite repepdamente y pox periodos prolgngados que estc eapucsui al polvo de la silice crist,dina o usar am
respnador apmbado d(.1 NIOSTf.
FI n sgo tic kt silicosis oriel cincer puhnonar dependc do la doractdn y do Ins nttel es do exposu.ion a In .flies.
Luse la Tioja de Datos's`otire In Segtiridad do. los Maleriabes (Ilaivada "Material Safety Bata Sheet") antes de usar n nutticlar este producto pars
determinar la ventilaciSn apropinda o In proiecciIin resliiratorlu riMsarht pars prowgci sii s;du(I. 4:1 Hoja do MINIS SOW la Scgaridad rue to Mwmalcs esta
dislinnihlc en nucsiro shin web www.ntariiunlarictia.Cirp o Ic pUCilc pcdir uta ski gcrgnte do pleura.
Marlik Marietta Materials
Page 1 of 1
V� IZ
P.O. Box 30013 FOR BILLINGI"QUESTIONS °PLEASE CALL
Raleigh, NC 27522 -0013
.Visit eRocks""at www.martinmarietta.com 317 573 -4460
JOB NAME: MISC JOB TAX EXEMPT TRK
SHIP TO:
SOLD TO: 00516 00772 MISCELLANEOUS JOB EXEMPT TRUCK
CITY OF CARMEL STREET DEPARTME TOWN HALL
3400 W 131ST STREET INDIANAPOLIS IN 46240
WESTFIELD IN 46074
PAYMENT TERMS: NET 30 DAYS A/R
Order No. Customer PO Dest Job No. Dist Business Business Unit Name Cust. No. Invoice Invoice No.
No. No. Unit Date
5141309 SO 001 888802 11 25102 North Indianapolis 231877 05/26/09 7711578
Ship Date Pr oduct I D escriptio n Quantity UM Unit Price Material Freight Freight Taxes TOTAL
B
Car N Na A mUuril Fiat@ I Amount Fees
05118/09 0637 N. NO. SC
075144 11.49 TN 13.70 157.41 157.41
*SUBTOTAL* 11.49 157.41 157.41
05/19/09 0637 IN, NO. 8C
075556 10.63 TN 13.70 145.63 145.63
*SUBTOTAL* 10.63 145.63 145.63
TOTAL 22.12 303.04 303.04
INVOICE TOTAL $303.04
Martir Marietta Materials Page 1 of 1
P.O. Box 30013 FOR BILLING. QUESTIONS PLEASE,CALL
Raleigh, NC 27622 -0013
317- $73 -4460
Visit eRocks''at www.martinmarietta.com
JOB NAME: MISC JOB TAXABLE TRK
SHIP TO:
SOLD TO: 00773 MISCELLANEOUS JOB TAXABLE TRUCK
CITY OF CARMEL- STREET DEPARTME CITY HALL
3400 W 131 ST STREET Indianapolis IN 46240
WESTFIELD IN 46074
PAYMENT TERMS: NET 30 DAYS AIR
Order No. Customer PO Dest Job No. Dist Business Business Unit Name Cust. No. Invoice Invoice No.
No. No. Unit Date
5141718 SO 002 888801 11 25103 Carmel Sand 231877 05/26/09 7711932
Ship Date Product Description Quantity UM Unit Price Material Freight Freight Taxes TOTAL
G5riBar a No. NO Arnounf Rate Amount Fees
05/19/09 0807 NO. 8
16607 11.00 TN 15.75 173.25 173.25
'SUBTOTAL' 11.00 173.25 173.25
TOTAL 11.00 173.25 173.25
INVOICE TOTAL $173.25
P 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
Martin Marie Materials Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/26/09 7711,978 Aksc- Supplies 05/26/09 7711932 Misc. Su $3Q3.Q4
Total M 2 9
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 N ®.6Q2XgWARRANT NO.
a aerials ALLOWED 20
OX 93186 IN SUM OF
Chicago, IL 6667.
$476.29
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
504 $303.04 materials or services itemized thereon for
1205 7711932 504 which charge is made were ordered and
received except
1205 0 501
12n5 bol $0.00
20
i n at r�
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund