209152 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 355466 Page 1 of 1
0 ONE CIVIC SQUARE KEITH FREER
CARMEL, INDIANA 46032 1413 N. FAIRVIEW STREET CHECK AMOUNT: $261.33
ALEXANDRIA IN 46001
CHECK NUMBER: 209152
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 261.33 OTHER EXPENSES
Walmart
Save money. Live better.
317 773 5212
MANAGER SAN JUAN RAMIREZ JR
16865 CLOVER RD
NOBLESVILLE IN 46060
ST# 0923 OP# 00000038 TE# 29 TR# 03436
COOKIE 007366408036 F 2.00 0
COOKIE 007366408036 F
59 AT 1 FOR 2.00 118.00 0
GV PARTY CUP 0681131-78398 1.98 X
GV PARTY CUP 068113178398 1.98 X
TC RAV RED 001117950218 0.97 X
TC RAV RED 001117950218 0.97 X
TC RAV RED 001117950218 0.97 X
TC RAV RED 001117950218 0:97, X
TC RAV RED 001117950218 0.97 X
TC RAV RED 001117950218 0.97 X
NAPKINS 001117931682 0.97 X
RED LUN NAP 001117990513
17 AT 1 FOR 1.97 33.49 X
PLATES 001117931685 0.97
HP BERRY LIM 001480064617 F
24 AT 1 FOR 2.28 54.72 X
SUBTOTAL 219.93
TAX 1 7.000 7.00
TOTAL 226.93
49W TEND 226.93
ACCOUNT *4m S
APPROVAL 009158
REF 213000073498
TERMINAL 41001114
05/09/12 18:44:28
CHANGE DUE 0.00
ITEMS SOLD 111
TC# 0942 0211 3210 1010 6649 6
11111111111111111 111111 II II II IIIII I I I I I 1111111
New. Place your order at Walmart.com
and Pay with cash at your store.
05/09/12 18:44:28
*CUSTOMER COPY
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Keith Freer
IN SUM OF
$261.33
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 120- 851.00 $226.93 1 hereby certify that the attached invoice(s), or
1120 120 851.00 $34.40 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
MAY 2.1 2012
Fire Chief
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))
$226.93
$34.40
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