180990 12/30/2009 (2) CITY OF CARMEL, INDIANA VENDOR: 359207 Page 1 of 1
ONE CIVIC SQUARE DAVID M TRICE
!i CHECK AMOUNT: $74.38
CARMEL, INDIANA 46032 PO BOX 1511
:r
NOBLESVILLE IN 46061 -1511 CHECK NUMBER: 180990
CHECK DATE: 12130/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
'1207 4239040 74.38 TIP
a
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
rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
i L�= Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
Jj
ON ACCOUNT OF APPROPRIATION FOR
C0f;1_)Eg,q4
/,20
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
oEPr- 1 hereby certify that the attached invoice(s), or
0 3y0- 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
C _)f 20 a
ci
i natu re
r-
Cost distribution ledger classification if Ti fi
claim paid motor vehicle highway fund