211671 08/14/2012 a CITY OF CARMEL, INDIANA VENDOR: 00351326 Page 1 of 1
ONE CIVIC SQUARE CARMEL CLAY HISTORICAL SOCIETY
O 211 FIRST STREET SW CHECK AMOUNT: $200.00
`a CARMEL, INDIANA 46032
CARMEL IN 46032 CHECK NUMBER: 211671
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4239099 200 . 00 OTHER MISCELLANOUS
Invoice
August 6, 2012
Carmel Clay Historical Society
211 15S St SW
Carmel, IN 46032
Attn: Katherine Due
Bill to: Carmel Clerk-Treasurer Diana Cordray
Copy of Bicentennial Print $200.00
Please mail the check to address listed above.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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))
Total
I 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.
ALLOWED 20
IN SUM OF $
&F�M�a I
ON ACCOUNT OF APPROPRIATION FOR
07T�- n ®4� I �
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
� j 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
20
A X
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund