214274 11/07/2012 ^�F CITY OF CARMEL, INDIANA VENDOR: 00353420 Page 1 of 1
ONE CIVIC SQUARE GEORGE W DAVIS CHECK AMOUNT: $14.36
CARMEL, INDIANA 46032 3854 CORNWALLIS LANE
CARMEL IN 46032 CHECK NUMBER: 214274
CHECK DATE: 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343003 14 .36 TRAVEL & LODGING
1
106 Street Grill
4335 W. 106th St.
Carmel, Indiana
(317)876-9203
Server: Tami DOB: 10/26/2012
12:30 PM 10/26/2012
Table 27/1 2/20002
SALE
Magnetic card present: DAY G, RGE W
Card Entry Method: S \
Approval : 603000
Amount• 11.97
7�5 �1 LLr II ,�, Z .fv
+ Tip: —
' Total :
I agree to pay the above
total amount according to the
card issuer agr eme
******Guest's Copy******
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))
10/26/12 history project $14.36
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.
ALLOWED 20
George W. Davis
IN SUM OF $
3854 Cornwallis Lane
Carmel, IN 46032
$14.36
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 43-430.03 $14.36
I hereby certify that the attached invoice(s), or
I I
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
Thursday, November 01, 2012
t
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund