167753 01/14/2009 CITY OF CARMEL, INDIANA VENDOR: T362354 Page 1 of 1
ONE CIVIC SQUARE STACEY SMILEY
CHECK AMOUNT: $440.00
CARMEL, INDIANA 46032 142 HARROWGATE DRIVE
CARMEL IN 46033 CHECK NUMBER: 167753
CHECK DATE: 111412009
"DEPARTME NT ACCOUNT PO NUMBER IN VOICE NUMBER AMO DESCRIPTION
x.601 5023990 440.00 REFUND
All
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABL VOUCHER
a TO
ADDRESS
Invoice Date Invoice Number Item Amount
o d X
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 correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
Mo. Day Yr. ffl r Title
Voucher N Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. PCCT
No.
CARMEL, INDIANA
Favor Of
sfa 57M
g f4a rrvL*l z j D r.
rmel 7- 4& 1
Total Amount of Voucher
Deductions
Amount of Warrant
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
Materiais and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FOAMS SYSTEMS 1 -800- 382 -8702 325