176031 08/18/2009 CITY OF CARMEL, INDIANA VENDOR: 358340 Page 1 of 2
ONE CIVIC SQUARE A T T LONG DISTANCE CHECK AMOUNT: $1,716.63
CARMEL, INDIANA 46032 PO Box 5017
CAROL STREAM IL 60197 -5017 CHECK NUMBER: 176031
CHECK DATE: 8/18/2009
DEPARTMENT ACC OUNT PO N INV OICE NUMBER AMOUNT DESC RIPTION
1110 4344000 3175712400 1,047.29 TELEPHONE LINE CHARGE
1115 4344000 3175712400 13.66 TELEPHONE LINE CHARGE
1120 4344000 3175712400 578.31 TELEPHONE LINE CHARGE
1125 4344000 3175712400 .40 TELEPHONE LINE CHARGE
1160 4344000 3175712400 15.88 TELEPHONE LINE CHARGE
1180 4344000 3175712400 1.85 TELEPHONE LINE CHARGE
1192 4344000 3175712400 11.74 TELEPHONE LINE CHARGE
1205 4344000 3175712400 11.68 TELEPHONE LINE CHARGE
1301 4344000 3175712400 3.92 TELEPHONE LINE CHARGE
1701 4344000 3175712400 3.37 TELEPHONE LINE CHARGE
2200 4344000 3175712400 2.27 TELEPHONE LINE CHARGE
2201 4344000 3175712400 .11 TELEPHONE LINE CHARGE
601 5023990 3175712400 5.77 OTHER EXPENSES
kti
3�
Y�
VENDOR'. 35834
p AZ LONG 1 0M ANCE Page 2 of 2
AR
OF c ME �Np�pN po eoxsoli
cHECK AMOUNT: $1,716.63
1V G `-�QV A RE 6032 CARO�SZREAMIL 60191 -5011 CHECK NUMBER: 176031
4
NA
pARME`.�Np�A CHECK DATE
8/18/2009
ACCOUNT PO N UMBE R INVOICE NUMBER AMOUNT DESCRIPTION
5023990 3175712400 15.35 OTHER EXPENSES
651 4344000 3175712400 3.14 TELEPHONE LINE CHARGE
9o2 4344000 3175712400 1.89 TELEPHONE LINE CHARGE
911
This is a summary of the ATT Long Distance billing for: 81112009
DEPARTMENT TOTAL
Administration $10.06
CCCC $13.6s
Clerk Treasurer $3.37
Court $3.92
CRC $3.14
DOCS $11.74
Drugs Task Force $1.89
Engineering $2.27
Fire $578.31 f
Law $1.85
Mayor $15.88
MIS $1.62,
Parks $0.401
Police 1,047.29
Sewer $10.07--
Sewer Dist $0.25
Street $0.11
Utilities $10.05
Water $0.75 f—
Water Dist $0.03
Grand Total $1,716.63
Monday, August 10, 2009 Page 1 of 1
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S 3 3 7
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
y IN SUM OF
V L--5)
1 q ;e lODlq
3. �31
ON ACCOUNT OF APPROPRIATION FOR
07� 4t-lo Ab
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
c �'I'j
Ala"AA )f--;
2
Signature
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
356463
AT T LONG DISTANCE Purchase Order No.
PO BOX 660688 Terms
DALLAS, TX 75266 -0688 Due Date 8/14/2009
Il
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/14/2009 5712262 $5.02
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 092738 WARRANT ALLOWED
f
356463 IN SUM OF
AT T LONG DISTANCE
PO BOX 660688
DALLAS, TX 75266 -0688
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
5712262 01- 6360 -07 $5.02
1
ti
Voucher Total $5.02
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
356463
AT T LONG DISTANCE Purchase Order No. al
PO BOX 5017 Terms U
Carol Stream, IL 60197 -5017 Due Date 8/14/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8114/2009 5712629 $0.25
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 096231 WARRANT ALLOWED
356463 IN SUM OF
AT T LONG DISTANCE
PO BOX 5017
Carol Stream, IL 60197 -5017
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
5712629 01- 7360 -01 $0.25
5 ?I 26w 01.362.05 f 0.0
01. 7360 -0� S .03
Voucher Total $0.
Cost distribution ledger classification if
claim paid under 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.
A T &T Long DisteRff
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Monthly Phone Service Admin $10.06
08/0 11vu 0 8 3900261 Monthly Phone Service IS $1.62
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& /17/09 WARRANT NO.
A T A T
ALLOWED 20
BOX 660686 IN SUM OF
Dallas, TX 75266 -0688
$11.68
ON ACCOUNT F APPROPRIATION FOR
�eneral Fund
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
ims 449 .6 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
1205 839002612 440 $1.62 which charge is made were ordered and
received except
20
Signature
TX
Title
Cost distribution ledger classification if
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 5017
Terms
Carol Stream, IL 60197 -5017
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n/a 08/01/09 Engineering Phones long distance $2.27
Total $2.27
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. B 501
Carol Stream, IL 60197 -5017
$2.27
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 08/01/09 ENG 4344000 $2.27 materials or services itemized thereon for
which charge is made were ordered and
received except
206
Signature
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))
08/13/09 Long Distance charges $11.74
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 Long Distance
IN SUM OF
P.O. Box 5017
Carol Stream, IL 60197 -5017
$11.74
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1192 43- 440.00 $11.74 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
Monday,,August 17, 2009
r
rector, DO
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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 Long Distance Purchase Order No.
P.O. Box 5017 Terms
Carol Stream, IL 60197 -5017 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/14/09 monthly payment 1,047.29
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
AT T Long Distance IN SUM OF
P.O. Box 5017
Carol Stream, IL 60197 -5017
1,047.29
ON ACCOUNT OF APPROPRIATION FOR
police ge neral fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 440 1,047 .29 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
August 14 20 09
U, J �40aa
Signature
Chief of Police
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 CAR.MEL
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
•st,gyet, Purchase Order No.
d 57D 77 Terms
.JP 60 7 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 9 Z
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
y O .5o 17
J,
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
.3 0 of o 3.9a 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 0
ignature
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))
08/01/09 I 839002612 I I $13.65
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
VO UCHER NO. WARRANT NO.
ALLOWED 20
AT &T Long Distance
IN SUM OF
P.O. Box 660688
Dallas, TX 75266 -0688
$13.65
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 839002612 43- 440.00 $13.65 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
Friday, August 14, 2009
Director
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))
08/01/09 $0.11
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
VOUCHE NO. WARRANT NO.
A T T Long Distance ALLOWED 20
IN SUM OF
P. O. Box 5017
Carol Stream, IL 60197 -5017
$0.11
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 43- 440.00 $0.11 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
Thur y, s 13, 2009
I loner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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.
358340 AT &T Long Distance Terms
P.O. Box 5017 Date Due
Carol Stream, IL 60197 -5017
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/1/09 1211568 Long Distance charges 0.40
Total 0.40
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.
358340 AT &T Long Distance Allowed 20
P.O. Box 5017
Carol Stream, IL 60197 -5017
In Sum of
0.40
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
I PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 1211568 4344000 0.40 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
13 -Aug 2009
Signature
0.40 Accounts payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I
Prewwibed 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
1` 7� _T C� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I
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
I
VQUCHER NO. WARRANT NO.
,Q ALLOWED 20
IN SUM OF
:]To i'7
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
I 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 b
ignature
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))
$578.31
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._ WARR NO.
AT T Long Distance ALLOWED 20
IN SUM OF
P.O. Box 5017
Carol Stream, IL 60197 -5017
$578.31
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 43- 440.00 $578.31 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
AUG 1 a
/7
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescri¢ed Stae Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
8/17/09 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. 0. Box 5017 Terms
Carol Stream IL 60197 -5017 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/1/09 83 002612 Long distance Ma
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
VO $CHEB O. WARRANT NO.
ALLOWED 20
AT&T IN SUM OF
P. 0. Box 5017
Carol Stream IL 60197 -5017
15.88
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4344000
Telephone Line Charges
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
839002612 4344000 $15.88 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
X17 20Ug
Signature
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
AT &T Long Distance
Purchase Order No.
P. O. Box 5017
Terms
Carol Stream, IL 60197 -5017
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8 -18 -09 Telephone Long Distance Charges per the attached $1.85
Statement 8/1/2009
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
AT &T LONG DISTANCE IN SUM OF
P:O. Box 5017
Carol S tr ea m, IL 60197 -5017
$1.85
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
430 -44000 Telephone Line Charges
Board Members
oE PT. INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
1180 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 p
t
gnature
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 of service rendered, by whom, rates per day, number of units, 0
price per unit, etc.
Payee
356463
AT T LONG DISTANCE Purchase Order No.
PO BOX 660688 Terms
DALLAS, TX 75266 -0688 Due Date 8/19/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/19/2009 5712255 $0.75
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 092748 WARRANT ALLOWED
X56463 IN SUM OF
AT T LONG DISTANCE -t
PO BOX 660688 jf
DALLAS, TX 75266 -0688
O p�vkl;��
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
5712255 01- 6360 -03 $0.75
Voucher Total 79
Cost distribution ledger classification if
claim paid under 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number 1 (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
j 0/ 7
ON ACCOUNT OF APPROPRIATION FOR
7ozi`35'ya�
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
qoz $O /Ol 3, 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
8 -2 200
Signature
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund