176569 08/25/2009 a CITY OF CARMEL, INDIANA VENDOR: 363284 Page 1 of 1
ONE CIVIC SQUARE CHERYL LANDIS
CARMEL, INDIANA 46032 3285 EDEN WAY. CIRCLE CHECK AMOUNT: $103.00
CARMEL IN 46033
CHECK NUMBER: 176569
CHECK DATE: 8/25/2009
DEPARTMENT ACCOUN PO NUM BER INV NUMBE AMOU DESCRIPTION
601 5023990 103.00 WATER OVERPAYMENT REF
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
ADDRESS KZdt l
Invoice Date Invoice Number Item Amount
I 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
Mo. Day Yr. Signature Title
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with lC 5- 11- 10 -1.6.
Mo. Day Yr. Officer Title
Voucher N W No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
N0.
CARMEL, INDIANA
11 Favor Of
Total Amount of Voucher
Deductions
Amount of Warrant 3 �Q
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation- Maintenance
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
i
Official Title
BOYCE FORMS SYSTEMS 1- 800- 382 -8702 325
I