178394 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363425 Page 1 of 1
ONE CIVIC SQUARE ERIN SMITH STARR
i e
�o CARMEL, INDIANA 46032 18719 PLANER DRIVE CHECK AMOUNT: $100.00
NOBLESVILLE IN 46062 CHECK NUMBER: 178394
CHECK DATE: 10/14/2009
.D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN DE SCRIPTION
101 5023990 100.00 OTHER EXPENSES
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995
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
E rj YA �IQ.ri Purchase Order No.
,Dr Terms
Alo b y 1 Date Due
a
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total o-fl
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with SC 5- 11- 10 -1.6.
,20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
r
ALLOWED 20
S 4-A :5 4z"-r,- IN SUM OF
/iln .b I e- s 0 J I 1- nl z
A"
ON ACCOUNT OF APPROPRIATION FOR
4�7
�L) ex n�
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
l oa39�d
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
0
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund