210836 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 366409 Page 1 of 1
ONE CIVIC SQUARE ED FERRER
CARMEL, INDIANA 46032 CIO ESE CHECK AMOUNT: $175.00
CHECK NUMBER: 210836
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 545930 175 . 00 TRAVEL FEES & EXPENSE
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Approval Date1�
CUSTOMER'S ORDER NO. DEPARTMENT DATE
DE ZO sllm Gf} i eLY z 7 J�2
NAME
G�RI�7� >D LE ��GNDOG. G�21RM
ADDRESS
CITY,STATE,ZIP
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SOLD BY CASH C.O.D. CHARGE ON ACCT. I MDSE RETD PAID OUT
QUANTITY DESCRIPTION PRICE AMOUNT
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RECEIVED BY
403k KEEP THIS SLIP FOR REFERENCE
ads RDC5805 ORIGINAL
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Carmel • Clay
P6rks&Recreation CHECK REQUEST
Date: May 11, 2012
Check payable to:
Name: Ed Ferrer
Address: 3947 Jekyll Ct.
City, State, Zip Indianapolis, IN 46237
Mail check to payee _x_Return check to requestor
Check Amount: $ 175 Date Required: July 27, 2012
Check needed for: Carmel Vacation Station Vendor
To be paid from:
PO#(if applicable)
Budget account-GL# 4340800 1082-1 (07kk U'!))
Budget Line Description Vendor
Invoice(s) and Purchase Order(if required)MUST be attached.
Requested by(print): Deneyse Solazzo
Requested by (signature):
Approved by(signature of Division Manager):
on this date IS'(,(11
Form revised 7-7-08 Shared/Forms/Business Services/Check Request Form/Check Request(rev 7-7-08)
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.
Ferrer, Ed Terms
3947 Jekyll Ct.
Indianapolis, IN 46237
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/27/12 545930 Snake program 7/27/12 Carmel Middle School $ 175.00
Total $ 175.00
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.
Ferrer, Ed Allowed 20
3947 Jekyll Ct.
Indianapolis, IN 46237
In Sum of$
$ 175.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-1 545930 4343000 $ 175.00 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
12-Jul 2012
Signature
$ 175.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund