212385 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 366506 Page 1 of 1
ONE CIVIC SQUARE AUSTIN SWIFT CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 151 ASPEN WAY
CARMEL IN 46032 CHECK NUMBER: 212385
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 100 . 00 GAZEBO DEPOSIT REFUND
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.
n Payee
lT cJ S 4-f rl S t,J T Purchase Order No.
e-") l_ J y Terms
_L_Al Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
VGt�z_eL C-) v , / Z 2-012—
p�
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 $
ON ACCOUNT OF APPR PRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
D 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
020
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund