179852 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 354829 Page 1 of 1
ONE CIVIC SQUARE JEREMY J SOUTH
CARMEL, INDIANA 46032 5151 SUNNYMEADF LANE CHECK AMOUNT: $175.00
INDIANAPOLIS IN 46208
CHECK NUMBER: 174852
CHECK DATE: 11/2412009
PARTMENT ACCOUNT PO NUMB INVOICE N UMBER A MOUNT DESCRIPTION
I,:.
1047 4340800 10/29/09 175.00 ADULT CONTRACTORS
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DATE
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ORDER NO.
NAME
ADDRESS nd
575) 5m SOLD BY F] CASH C.O.D. 'PAID OUT
CHARGE MERCHANDISE RETURNED
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PAX
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NC2581 SIGNATURE
ALL CLAIMS AND URNED O S MUST BE ACCOMPANIED BY THIS BILL.
�E�iE L P LW3
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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
Purchase Order No.
354829 South, Jeremy Terms
5151 Sunny Meade Ln
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/29109 10/29/09 Preschool pottery 22868 p 175.00
Total 175.00
1 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. Warrant No.
354829 South, Jeremy Allowed 20
5151 Sunny Meade Ln
Indianapolis, IN 46208
In Sum of
175.00
y ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept ept INVOICE NO. ACCT #/TITLE AMOUNT
1047 10/29/09 4340800 175.00 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
19-Nov 2009
Signature
175.06 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund