169626 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 00350034 Page 1 of 1
ONE CIVIC SQUARE DONALD R SIMPSON
CARMEL, INDIANA 46032 633 E QUAIL RIDGE DR CHECK AMOUNT: $7.00
v WESTFIELD IN 46074
CHECK NUMBER: 189626
CHECK DATE: 3/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D ESCRIPTION
601 5023990 7.00 REIMBURSEMENT
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PORIK. GARAGE
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pcpt# 34387
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Cash Tender iO. 00
Change Due 3�. 00
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Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T0716
SIMPSON, DON Purchase Order No.
CARMEL WATER Terms
Due Date 2/24/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/24/2009 22409 $7.00
r_
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
Date Officer
VOUCHER 091209 WARRANT ALLOWED
T0716 IN SUM OF
SIMPSON, DON
CARMEL WATER
r ®P EP O
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
22409 01- 6040 -05 $7.00
Voucher Total $7.00
Cost distribution ledger classification if
claim paid under vehicle highway fund