HomeMy WebLinkAbout179971 12/07/2009 CITY OF CARMEL, INDIANA VENDOR: 363628 Page 1 of 1
ONE CIVIC SQUARE RITCH SHEPHERD
CARMEL, INDIANA 46032 7513 OCEANLINE DRIVE CHECK AMOUNT: $125.00
INDIANAPOLIS IN 46214 CHECK NUMBER: 179971
CHECK DATE: 12/7/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
4601 5023990 125.00 REFUND
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
TO 1
ADDRESS r YZ
Invoice Date Invoice Number Item Amount
r:
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�uS Lr.s G. 1K a (2 C6
s s' z oo rs 4J�.
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
I hereby certify that the attached invoice(s), or bill(s), is (are) true and co ect and I have audited same in accordance
with IC 5- 11- 10 -1.6.
Mo. Day Yr. 7� Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
CARMEL, INDIANA
Favor Of
kQ r' c
7sr3 pc�ac.•� f K
.L�tw/e.n I. zve A-5
Total Amount of Voucher
Deductions
Amount of Warrant
Month of Yr
VOUCHER RECORD Acct.
Na.
Source of Su pply
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
Official Title
SCYCE FORMS SYSTEMS 1- 800 -382 -8702 325