174694 07/22/2009 ��g CITY OF CARMEL, INDIANA VENDOR: 359662 Page 1 of 2
ONE CIVIC SQUARE A T T CHECK AMOUNT: $8,012.52
CARMEL, INDIANA 46032 PO BOX 8100
AURORA IL 60507 -8100 CHECK NUMBER: 174694
«o
CHECK DATE: 7122/2009
DEPART ACCOUNT PO NUMBER IN VOICE NU MBER AMO UNT DESCRIP
1110 4344000 3175712400 1,639.89 TELEPHONE LINE CHARGE
1115 4344000 3175712400 934.30 TELEPHONE LINE CHARGE
1120 4344000 3175712400 1,325.27 TELEPHONE LINE CHARGE
1125 4344000 3175712400 107.57 TELEPHONE LINE CHARGE
1160 4344000 3175712400 256.24 TELEPHONE LINE CHARGE
1180 4344000 3175712400 176.32 TELEPHONE LINE CHARGE
4 1192 4344000 3175712400 555.25 TELEPHONE LINE CHARGE
1205 4344000 3175712400 705.20 TELEPHONE LINE CHARGE
1301 4344000 3175712400 214.96 TELEPHONE LINE CHARGE
1701 4344000 3175712400 209.57 TELEPHONE LINE CHARGE
2200 4344000 3175712400 278.22 TELEPHONE LINE CHARGE
2201 4344000 3175712400 50.45 TELEPHONE LINE CHARGE
601 5023990 3175712400 611.96 OTHER EXPENSES
CITY OF CARMEL, INDIANA VENDOR: 359662 Page 2 of 2
ONE CIVIC SQUARE AT&T
CARMEL, INDIANA 46032 PO BOX 8100 CHECK AMOUNT: $8,012.52
AURORA IL 60507 -8100
CHECK NUMBER: 174694
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 3175712400 504.19 OTHER EXPENSES
902 4344000 3175712400 262.55 TELEPHONE LINE CHARGE
911 4344000 3175712400 180.58 TELEPHONE LINE CHARGE
CARMEL CITY OF Page 1 of 4
ATTN JANET ARNONE Account Number 317 571 -2400 053 2
31 1ST AV NW Billing Date Jul 7, 2009
CARMEL, IN 46032 -1715
Web Site att.COM
at &t Invoice Number 317571240007
Monthly Statement
Jun 8 Jul 7, 2009
Previous Bill 8,271.28 Total AT &T Savings 17.61
Payment Received 6 -25 Thank You 8,271.28CR
Adjustments .00
s
Balance .00 Monthl Service Jul 7 thru Au 6
Customer Service Record
Current Charges 8,012.52 2 reports S 5.00 ea 10.00
Monthly Charges 7,748.55
Total Amount Due $8,012.52 Total Monthly Service 7,758.55
Additions and Chan to Service
1 Amount Due in Full by Jul 31, 2009 (Computed from Service Date to Billing Date)
This section of your bill reflects charges and credits resulting from
account activity.
Item Monthly Amount
r No. Descri Quantit USOC Rate Billed
Main Line 317 571 -2400
Questions? Visit att.corn. Date: Jul 7, 2009
Order Number R9034137555
Plans and Services 8,012.52 Effective Jul 1, 2009, your
1- 800 480 -8088 Bill reflects an increase of
Repair Service: S.75 in your Monthly
1- 800 727 -2273 Service charges. Charges are
prorated from Jul 1, 2009
Total of Current Charges 8,012.52 dlru Jul 6, 2009 v
1. Monf111y Service .15
Total Charges for Order Number R9034137555 .15
Total Charges for Main Line 317 571 -2400 .15
Station 317 571 -2364
Date: Jun 29, 2009
Order Number R1872715298
Services Removed:
2. Station Cell Size 21 -100 1 NRSX2 10.00 2.33CR
3. Federal Universal Service Fee 1 9PZLX .13 03 R
Total Credits for Order Number R1872715298 2,36CR
Order Number 81872715299
Services Added:
4. Station Cell Size 21 -100 1 NRSX2 10.00 2.33
5. Federal Universal Service Fee 1 9PZLX .13 .03
Total Charges for Order Number R1872715299 2.3
Total Charges for Station 317 571 -2364 0
Station 317 571 -2468
Date: Jun 29, 2009
Order Number 81872715298
Services Removed:
PREVENT DISCONNECT •CARRIER CHANGE 6. Station Cell Size 21 -100 1 NRSX2 10.00 2.33CR
AT &T PRIVACY POLICY FEDERAL FEE INCREASE
See "News You Can Use" for additional information.
Local Services provided by AT &T Illinois, AT &T Indiana, AT &T Michigan,
AT &T Ohio or AT &T Wisconsin based upon the service address location.
Return bottom portion with your check in the enclosed envelope. U.S. Pat. D410,960 and D414,510 Printed on Recyclable Paper
CARMEL CITY OF Page 2 of 4
ATTN JANET ARNONE Account Number 317 571 -2400 053 2
x
31 1ST AV NW Billing Date Jul 7, 2009
at &t
CARMEL, IN 46032 -1715
f Invoice Number 317571240007
Plans and Services W
Additions and Chan to Service Continued
Item Montltly Amount
Additions and Chan to Service Continued No. Descri Quantit USOC Rate Billed
Item Monthly Amount Station 317 571 -2631
No. Descri Quantit USOC Rate Billed Date: Jul 7, 2009
Order Number R9034137555
1. Federal Universal Service Fee 1 9PZLX .13 P R Effective Jul 1, 2009, your
Total Credits for Order Number R1872715298 '36CR
Bill reflects an increase of
Order Number 81872715299 $7.38 in your Monthly
Service charges. Charges are
Services Added:
2. Station Cell Size 21 -100 1 NRSX2 10.00 2.33 rated from Jul 1, 2009
prorated
Jul 6, 2009
3. Federal Universal Service Fee 1 9PZLX .13 0 16. Monthly Service J:1.
Total Charges for Order Number 81872715299 6 Total Charges for Order Number 89034137555 Total Charges for Station 317 571 -2468 0 .0 Total Charyes for Station 317 571 -2631
Station 317 571 -2509
Date: Jun 29, 2009 Station 317 571 -2666
Date: Jun 29,
Order Number R1872715302 r R1
Services Removed: Order Number 81872715305
Services Removed:
4. Electronic Tel -Set Service 1 ETJ 1.50 .35CR 17. Station Cell Size 1 -20 1 NRSX1 10.00 2.33C
5. Station Cell Size 21 -100 1 NRSX2 10.00 2.33C 18. Federal Universal Service Fee 1 9PZLX .13 .0
6. Federal Universal Service Fee 1 9PZLX .13 R Total Credits for Order Number 81872715305 6CR
Total Credits for Order Number R1812715302 1CR
Order Number 81872715303 Order Number 81872715306
Services Added:
Services Added: 19. Station Cell Size 1 -20 1 NRSX1 10.00 /2.33 7. Electronic Tel Set Service 1 ETJ 1.50 /2.33 20. Federal Universal Service Fee 1 9PZLX .13 8. Station Cell Size 21 100 1 NRSX2 10.00 Total Charyes for Order Number R1872715306 9. Federal Universal Service Fee 1 9PZLX .13 Total Charyes for Station 317 571 2666
Total Charges for Order Number 81872715303 Total Charges for Station 317 571 -2509 Station 317 571 -5855
Station 317 571 -2563 Date: Jun 29, 2009
Date: Jun 29, 2009 Order Number R1872715300
Order Number 81872715302 Services Removed:
Services Removed: 21. Station Cell Size 21 -100 1 NRSX2 10.00 .2.330
10. Electronic Tel -Set Service 1 ETJ 1.50 /3R 22. Federal Universal Service Fee 1 9PZLX .13 0 11. Station Cell Size 21 -100 1 NRSX2 10.00 Total Credits for Order Number R1872715300 6CR
12. Federal Universal Service Fee 1 9PZLX 13 Order Number 81812715301
Total Credits for Order Number R1872715302 Services Added:
Order Number R1872715303 23. Station Cell Size 21 -100 1 NRSX2 10.00 2.33
Services Added: 24. Federal Universal Service Fee 1 9PZLX .13
13. Electronic Tel Set Service 1 ETJ 1.50 .35 Total Charges for Order Number R1872715301 .36
14. Station Cell Size 21-100 1 NRSX2 10.00 P.3 Total Charges for Station 317 571 -5855 .00
15. Federal Universal Service Fee 1 9PZLX .13 3 Station 317 571 -5856
Total Charges for Order Number R1872715303 .71
Total Charges for Station 317 571 -2563 .00 Date: Jun 29,
Order Number r R1 81872715300
Services Removed:
25. Station Cell Size 21 -100 1 NRSX2 10.00 2.33CR
26. Federal Universal Service Fee 1 9PZLX .13 Q3CR
Total Credits for Order Number 81872715300 �2.36CR
Order Number 81872715301
Services Added:
27. Station Cell Size 21 -100 1 NRSX2 10.00 2.33
Y�
O 2006 AT &T Knowledge Ventures. All rights reserved.`•
9491.002.017339.01.04.0000000 N N N N N N N Y 34697.34697
3 Now
n CARMEL CITY OF Page 3 of 4
ATTN JANET ARNONE Account Number 317 571 -2400 053 2
at&t 311STAVNW Billing Date Jul 7,2009
CARMEL, IN 46032 1715
Invoice Number 317571240007
Local Toll
No. Date Time Place Called Number Code Min
Additions and Changes to Service Continued Calls Charged to 317 571 -2582
Item Monthly Amount 411 and 555 -1212
No. Description Quantity USOC Rate Billed 2 Listing(s) billed at $1.50 each
1. Federal Universal Service Fee 1 9PZLX .13 .03 Calls Charged to 317 571 -2775
Total Charges for Order Number R1872715301 Itemized Calls
Total Charges for Station 317 571 -5856 .00 1 6 -08 1051A ANDERSON IN 765 620 -1903 D 1:06# .09
Station 317 818 -9301 2 6 -08 1151A GREENTOWN IN 765 628 -3398 D 0:24# .03
Date: Jun 29,2009 3 6 -10 845A KOKOMO IN 765 438 -7104 D 0:429 .06
Order Number R1872715295 4 6 -10 916A KOKOMO IN 765 438 -7104 D 0:36# .05
5 6 -10 930A KOKOMO IN 765 438 -7104 D 5:30# .45
Services Removed: 6 6 -15 1054A CICERO IN 317 385 -4533 D 2:54# .24
2. Station Cell Size 21 -100 1 NRSX2 10.00 2.33CR/ 7 6 18 1243P CICERO IN 317 385 4533 D 2:12# 18
3. Federal Universal Service Fee 1 9PZLX 13 .03CR 8 6 -24 426P GREENCASTL IN 765 720 -7430 D 3:00# .25
Total Credits for Order Number R1872715295 2.366 g 6 -30 158P GREENCASTL IN 765 720 -7430 D 0:42# .06
Order Number 81872715296 10 6 -30 334P GREENCASTL IN 765 720 -7430 D 4:18# .35
11 6 -30 359P GREENCASTL IN 765 720 -7430 D 0:30# .04
Services Added: 12 7 -02 1002A GREENCASTL IN 765 720 -7430 D 0:24# .03
4. Station Cell Size 21 100 1 NRSX2 10.00 2.33 Total Itemized Calls 1.83
5. Federal Universal Service Fee 1 9PZLX .13 .03 Total Calls Charged to 317 571 -2775 1.83
Total Charges for Order Number 81872715296 2
Total Charges for Station 317 818 -9301 .00 Calls Charged to 317 571 -2790
Station 317 818 -9335 Itemized Calls
13 6 -30 425P WHITELAND IN 317 535 -4291 D 1:24# .11
Date: Jun 29, 2009 Total Itemized Calls .11
Services Reemovemoved:
Order Number 1 Total Calls Charged to 317 571 -2790 .11
6. Station Cell Size 101 -250 1 NRSX3 10.00 2.33/CR Charge includes your Intralata Usage
7. Federal Universal Service Fee 1 9PZLX .13 DSCR Special Rate Plan.)
Total Credits for Order Number R1872715292 �2.36CR
Order Number R1872715294 Your Intralata Usage Special Rate Plan
Services Added: saved you $17.61 this month.
8. Station Cell Size 101 -250 1 NRSX3 10.00 2.33 Key for Calling Codes:
9. Federal Universal Service Fee 1 9PZLX .13 D Day
Total Charges for Order Number R1872715294 Total Charges for Station 317 818 -9335 Total Local Toll 1.94
Station 317 818 -9336
Date: Jun 29, 2009 Surcharges and Other Fees
Order Number R1872115292 9 -1 -1 Emergency System
Services Removed: Billing for more than one city /counties 151.28
10. Station Cell Size 101 -250 1 NRSX3 10.00 2.33CR/ Federal Universal Service Fee 55.35
11. Federal Universal Service Fee 1 9PZLX .13 03 IN Universal Service Surcharge 38.42
Total Credits for Order Number R1872715292 236CR Telecommunications Relay System 2.35
Total Surcharges and Other Fees 247.40
Order Number 81872715294 r
Services Added: Total Plans and Services 8
12. Station Cell Size 101 -250 1 NRSX3 10.00 2.33
13. Federal Universal Service Fee 1 9PZLX .13 03
Total Charges for Order Number R1872715294 2.
Total Charges for Station 317 818 -9336 1 .00
Total Additions and Changes to Service C63
Information Charges
411 and 555 -1212
2 Listing(s) requested from 1 +411
2 Listings) billed at $1.50 each 3.00
CARMEL CITY OF Page 4 of 4
ATTN JANET ARNONE Account Number 317 571 -2400 053 2
311STAVNW Billing Date Ju17,2009
a
at&t CARMEL, IN 46032 -1715
Invoice Number 317571240007
PREVENT DISCONNECT
Thank you for being a valued customer. It is important to inform you
that all charges must be paid each month to keep your account current
and prevent collection activities. In addition, please be aware that
we are required to inform you of certain charges that MUST be paid in
order to prevent interruption of basic local service. These charges
are already included in the Total Amount Due and are 58,002.52.
If you don't agree with the amount due, you should dispute the portion
you disagree with before the payment due date.
CARRIER CHANGE
Our records indicate that your primary local toll and
long distance companies have changed. The new company is
AT &T Long Distance or a company whose services are
billed by this company. Your new company has agreed to pay the fee for
changing long distance companies. Please contact us if this does not
agree with your records.
AT &T PRIVACY POLICY
AT &T has updated its privacy policy. Visit www.attcom /privacy to
review the updated privacy policy and learn more about our commitments,
privacy safeguards and customer choices. Thank you for choosing AT &T.
FEDERALFEEINCREASE
Effective 7/1/2009, the Federal Universal Service Fee (supports
telecommunication needs of low- income households, consumers living in
high -cost areas, schools, libraries and rural hospitals), and the
Federal Subscriber Line Charge have increased. Lifeline customers will
continue to receive credit for the Federal Subscriber Line Charge.
Your current bill reflects the change. For more information, please
contact an AT &T Service Representative at the phone number listed on
the front of your bill. Thank you for choosing AT &T.
r'
9491.002.017339.02.04.0000000 NNNNNNNY 21601.21601
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
r Payee
Ll Purchase Order No.
l`/ b
1 0 v 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.
I ALLOWED 20
'747�,
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 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
20
Signatur
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
.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
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
AT &T
Purchase Order No.
P.O. Box 8100
Terms
Aurora, IL 60507 -8100
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/07/09 Local phone lines Engineering $278.22
Total $278.22
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.
ALLOWED 20
AT&T IN SUM OF
P.O. Box 8100
Aurora, IL 60507 -8100
$278.22
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
n/a 07/07/09 ENG 4344000 $278.22 materials or services itemized thereon for
which charge is made were ordered and
received except
j20 20
Signature
tc\ c SyL'4�
Cost distribution ledger classification if Tltle
claim paid motor vehicle highway fund
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
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
AT &T
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/07/09 Monthly Local Phone Service Admin $368.36
07/07/09 Monthly Local Phone Service IS $336.84
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 N(9 NO.
AT 9 Tz ALLOWED 20
P. Box 8100 IN SUM OF
Aurora, IL 60507 -8100
$705.20
ON ACCOUNTdF �PP FOR
1205 Administration
Board Members
PO# or
DEPT. INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
1205 440 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
440 $336.84 which charge is made were ordered and
received except
20
i
U ignawre
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescrih,ed 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
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
A T Purchase Order No.
P .O. Box 8100 Terms
A urora, IL 60507 -8100 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/17/09 monthl payment 1,639.89
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
A T IN SUM OF
P.O. BOX 8100
Aurora, IL 60507 -8100
1,639.89
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 440 1,639.89 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
July 17 20 09
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/07/09 I 317571240007 I I $934.30
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
V OUCHER NO. W ARRANT NO.
ALLOWED 20
AT &T
IN SUM OF
P.O. Box 8100
Aurora, IL 60507 -8100
$934.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 317571240007 43- 440.00 $934.30 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
Friday, July 17, 2009
4we
Directo
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
1
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/07/09 Line charges $555.25
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
1
VOUCHER NO. WARRANT NO.
ALLOWED 20
ATT
IN SUM OF
P.O. Box 8100
Aurora, IL 60507 -8100
$555.25
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1192 43- 440.00 $555.25 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
nday, July 20, 2009
irector CS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$1,325.27
1 hereby certify that the attached invoice(s), or bi11(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
PT &T
IN SUM OF S
P.O. Box 8100
Aurora, IL 60507 -8100
S1,325.27
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 43- 440.00 $1,325.27 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
JUL 2 4 2009
lit
V-, ,Pv�
I U
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed b1j 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
00/00 Terms
a.S a 60P9 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
ALLOWED 20
IN SUM OF
0.
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE MOUNT
DEPT. I hereby certify that the attached invoice(s), or
96 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
2
Cost distribution ledger classification if Title f
claim paid motor vehicle highway fund