211546 08/06/2012 CITY OF CARMEL, INDIANA VENDOR: 366453 Page 1 of 1
ONE CIVIC SQUARE SCOTT THORNBURGH
CARMEL, INDIANA 46032 13820 SPRINGMILL PONDS CIRCLE CHECK AMOUNT: $6,569.69
s?� CARMEL IN 46032
CHECK NUMBER: 211546
CHECK DATE: 8/6/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 6 , 569 . 69 REFUND
Prescribed by State Board of Accounts
Form No.301 (Rev.1995) ACCOUNTS PAYABLE VOUCHER
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To-Sv ern L / /�
ADDRESS /3�ZU S r/n /7t, �` O/Z�/S `mss! r
Invoice Date Invoice Number Item Amount Sao �3Z
73i z Scot TGi o,-n LLZr
p5' -2.23-3
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
Mo. Day Yr. Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (are)true arld corr ct and I have audited same in accordance
with IC 5-11-10-1.6.
Mo. Day Yr. 116cer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ' ACCT.
NO.
CARMEL, INDIANA
Favor O
Sc a ft TA oe",K Cc r
Total Amount of Voucher $
,
Deductions I
I
0 �
I
i
Amount of Warrant $
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed-
Board of Control
Filed
Official Title
BOYCE FORMS•SYSTEMS 1-800-382-8702 325