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213532 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: T357033 Page 1 of 1 t�tONE CIVIC SQUARE SHARON KIBBE CHECK AMOUNT: $7.47 ° CARMEL, INDIANA 46032 827 WINTER CT CARMEL IN 46032 CHECK NUMBER: 213532 CHECK DATE: 10/9/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1160 4355100 7 . 47 PROMOTIONAL FUNDS �21mb�r5� � � •�1 �ha waoThere's a wayr"` #03231 1215 S RANGE LINE RD CARMEL IN 46032 317-�71-1176 550 0462 0022 09/24/2012 4;06 PM H/MARK MED G/BAG FROSTED DOTS PPR 79590208218 A 7.47 3 @ 2.49 SUBTOTAL 7;47 SALES TAX A=7.0% TOTAL 7.99 VISA ACCT 7342 7.090 THANK YOU FOR SHOPPING AT WALGREENS DID YOU KNOW THAT YOU CAN EARN POINTS' ON HUNDREDS OF ITEMS IN-STORE AND ONLINE? SEE OUR WEEKLY AD FOR MORE . INFORMATION. RESTRICTIONS APPLY. SEE PROGRAM RULES FOR DETAILS. RFN# 0323-1220-4620-1209-2403 Illlliltllllllllllllllllllll11111111111III1111II111IIII11111111111111111Illll ll balance'' rewards How are we doing? Enter our monthly sweepstakes for $3 , 000 cash Visit WWW . WAGCARES . COM or call toll free. 1 -800-658- 1584 . within 72 hours to take a short survey about this Walgreens visit SURVEY# - 0323- 1220-462 PASSWORD 9240-321 0120— For contest rules see store or WWW.WAGGAhS.COM VOUCHER NO. WARRANT NO. ALLOWED 20 Sharon Kibbe IN SUM OF $ 827 Winter Court Carmel, IN 46032 $7.47 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1160 Receipt 43-551.00 $7.47 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 Friday, October 05, 2012 f � - May r 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)) 09/24/12 Receipt $7.47 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