209371 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 00350407 Page 1 of 1
ONE CIVIC SQUARE CLARK TILSON
CARMEL, INDIANA 46032 11231 ROLLING SPRINGS DRIVE CHECK AMOUNT: $5.00
CARMEL IN 46033 CHECK NUMBER: 209371
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4358200 5.00 SPECIAL INVESTIGATION
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Drg. Fee: 5.110
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VOUCHER NO. WARRANT NO.
ALLOWED 20
T. Clark Tilson
IN SUM OF
11231 Rolling Springs Drive
Carmel, IN 46033
$5.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1110 43- 582.00 $5.00
I hereby certify that the attached invoice(s), or
I 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
Thursday, May 17, 2012
Chief of Police
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))
05/16/12 reimbursement for parking $5.00
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