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178395 10/14/2009 CITY OF CARMEL, INDIANA VENDOR 354829 Page 1 of 1 ONE CIVIC SQUARE JEREMY J SOUTH CARMEL, INDIANA 46032 5151 SUNNYMEADE LANE CHECK AMOUNT: $300.00 INDIANAPOLIS IN 45208 CHECK NUMBER: 178395 CHECK DATE: 10/1412009 DEP ARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4340800 1006 300.00 ADULT CONTRACTORS 3 N®. 5 1 5 1 J )vl y �'C/� GF�✓� DATE °ORDER NO: NAME ADDRESS SOLD BY j PAID OUT CHARGE-,': MtERCHANDISE:RETURNED QUANTITY zi r tY� r 4! 0 JUIJV Y f. Purchase ej t} P.O. I P F G.L.. Line esct s a Approval NC2581 SIGNATURE ALL CLAIMS D RETU ED ODDS MIDST BE ACCOMPANIED BY THIS BILL. GE RAI URPOSE 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 8/5/09 1006 Pottery classes 20714 p 300.00 Total 300.00 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 f Voucher No. Warrant No. 354829 South, Jeremy Allowed 20 5151 Sunny Meade Ln Indianapolis, IN 46208 In Sum of 300.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 1006 4340800 300.00 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 7 -Oct 2009 Signature 300.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund