207958 04/10/2012 \,f CITY OF CARMEL, INDIANA VENDOR: 364085 Page 1 of 1
ONE CIVIC SQUARE MADISON COUNTY COUNCIL OF GOVT HECK AMOUNT: $250.00
CARMEL, INDIANA 46032 16 E 9TH STREET
ANDERSON IN 46016 CHECK NUMBER: 207958
CHECK DATE: 4110/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
211 4462838 0 250.00 STORM WATER PHASE II
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Madison Count Council of G wernmcas
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Make checks payable to:
Madison County Council of Governments
16 E. 9' St.
Anderson, IN 46016
Phone: 765.641.9482
Contact: Laura Sylvester
lsylvester@mccog.net
PO /Check f5 7
Date '3-
Description 2012 Indiana MS4 Annual Conference
Registration May 17`", 2012
Issued to (insert your information here):
Registrant Description Amount Due
Conference Registration $50.00
Total $50.00
*Multiple registrants from one community /organization can submit a single check for total
payment. However, please include a copy of each individual registrant invoice with the check.
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Mad Ownty Council of Givcrnmcnb
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Make checks payable to:
Madison County Council of Governments
16 E. 9' St.
Anderson, IN 46016
Phone: 765.641.9482
Contact: Laura Sylvester
Sylvester@mccog.net
PO /Check Z,
Date 'Z
Description 2012 Indiana MS4 Annual Conference
Registration May 17` 2012
Issued to (insert your information here):
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Re istrant Description Amount Due
!"n w 61 Conference Registration $50.00
Total $50.00
*Multiple registrants from one community /organization can submit a single check for total
payment. However, please include a copy of each individual registrant invoice with the check.
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Madison Owtv Council of Governmem
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Make checks payable to:
Madison County Council of Governments
16 E. 9" St.
Anderson, IN 46016
Phone: 765.641.9482
Contact: Laura Sylvester
Isylvester@mccog.net
PO/Check
Date
Description 2012 Indiana MS4 Annual Conference
Registration May 17', 2012
Issued to (insert your information here):
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C-CA-YKE 0
Registrant Description Amount Due
Conference Registration $50.00
Total $50.00
*Multiple registrants from one community/organization can submit a single check for total
payment. However, please include a copy of each individual registrant invoice with the check.
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Madison Gmm Council of Go ernmrnb
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Make checks payable to:
Madison County Council of Governments
16 E. 9ch St.
Anderson, IN 46016
Phone: 765.641.9482
Contact: Laura Sylvester
Iylvester @mccog.net
PO /Check
Date
Description 2012 Indiana MS4 Annual Conference
Registration May 17` 2012
Issued to (insert your information here):
GJ���Lan Gam f in.�G v✓
Registrant Description Amount Due
G o•r A a Conference Registration $50.00
Total $50.00
*Multiple registrants from one community /organization can submit a single check for total
payment. However, please include a copy of each individual registrant invoice with the check.
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Madison County Council of Covernmcnt.
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Make checks payable to:
Madison County Council of Governments
16 E. 9" St.
Anderson, IN 46016
Phone: 765.641.9482
Contact: Laura Sylvester
lylvester @mccog.net
PO /Check 2 �K 7
Date .2-- 2-
Description 2012 Indiana MS4 Annual Conference
Registration May 17 2012
Issued to (insert your information here):
�vh� T'h Gaffs
Registrant Description Amount Due
'J h.-, 7 r-1 w s Conference Registration $50.00
Total $50.00
*Multiple registrants from one community /organization can submit a single check for total
payment. However, please include a copy of each individual registrant invoice with the check.
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
Madison County Council of Governments Purchase Order No.
16 E. 9th Street Terms
Anderson, IN 46016 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s) Amount
2/26/2012 0 2012 IN MS4 Annual Conference 250.00
Total 250.00
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
VOUCHER NO. WARRANT NO.
Madison County Council of Governments ALLOWED 20
IN SUM OF
16 E. 9th Street
Anderson, IN 46016
250.00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po #or INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoices or
DEPT# y cer y invoice s)
n/a 0 211 4462838 250.00 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
4/9/2012
Signature
City Engineer
Cost Distribution ledger classification if claim paid motor Title
vehicle highway fund
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