214572 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 027235 Page 1 of 1
ONE CIVIC SQUARE BOSE,MCKINNEY&EVANS CHECK AMOUNT: $4,780.00
CARMEL, INDIANA 46032 111 MONUMENT CIRCLE,SUITE 2700
INDIANAPOLIS IN 46204 CHECK NUMBER: 214572
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4340000 554447 346 . 50 LEGAL FEES
1180 4340000 554448 94 . 50 LEGAL FEES
610 5023990 554450 306 . 00 OTHER EXPENSES
1180 4340000 555127 976 . 50 LEGAL FEES
301 5023990 555127 2, 886 . 50 OTHER EXPENSES
610 5023990 555129 170 . 00 OTHER EXPENSES
B®SE MAIL REMITTANCES TO:
McK I Y 111 Monument Circle,Suite 2700
& EVANS LLP I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
ATTN: Douglas C. Haney October 5, 2012
One Civic Square Invoice No. 555127
Carmel, IN 46032 Fed. I.D. 35-0957980
10-29-12PO5 : 41 RCVD
For Legal Services in Connection With:
Matter: 008824-0015 General Review and Preparation of Contracts,
Easements and Related Documents
09/07/12 J. Hamilton 0.1 34.00 Phone call with Doug Haney
regarding health clinic.
09/10/12 J. Hamilton 0.3 102 .00 Phone call with Barb Lamb
regarding interaction of
clinics and HSAs; email to
Barb Lamb regarding same.
09/12/12 J. Hamilton 3 .4 1, 156.00 Review of HSA guidance;
drafting of memo to Barb
Lamb.
09/13/12 D. Meyer 1.2 516.00 Review, research and revise
memorandum regarding
on-site clinics that
provide significant medical
services to HSA eligible
participants.
09/14/12 J. Hamilton 0.3 102 .00 Review of clinic memo;
transmittal to Barb Lamb.
09/19/12 B. Babb 3 .1 976.50 Attention to: continue
engaging in post-mediation
discussion to coordinate
settlement; conference with
Mayor regarding same.
Total for Services $2, 886 .50
J C) .U(� Total This Invoice $2,886 .50
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
BOSE MCKINNEY & EVANS LLP Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10105H2 555!27 General Rev4ew & Prep GentFaet $2,886.50
Total $2,886.50
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.
11 TT97T2
ALLOWED 20
R- OSE MCKINNFY & Evans 1 1 12 — IN SUM OF $
111 Mon,iment Circle, Sa iitP 970n
ndi2R;4nr)lic IN � RF QZI
T
ON ACCOUNT OF APPROPRIATION FOR
301 Mac]IC21 Fl Ind
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
�BOSE MAIL REMITTANCES'T0:
1'i cKINNE i 111 Monument Circle,Suite 2700
& EVAN►S LLP I n v o i c e Indianapolis, Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
ATTN: Douglas C. Haney September 19, 2012
One Civic Square Invoice No. 554448
Carmel, IN 46032 Fed. I .D. 35-0957980
'1-29-1 ?P06 RC
For Legal Services in Connection With: 0 `
Matter: 008824-0054 Appeal of Homeplace Annexation
08/14/12 B. Babb 0 .3 94 .50 Follow up with Buschmann
regarding the telephone
status conference and
calendar same; call the
Court to determine the
preferred procedure; send
email update to Doug Haney.
Total for Services $94.50
Total This Invoice $94.50
OUTSTANDING INVOICES:
DATE NUMBER AMOUNT CREDITS BALANCE
08/13/12 551254 $126 .00 $ .00 $126.00
Prior Outstanding Balance $126.00
Total Balance Due $220 .50
BdSE MAIL REMITTANCES TO:
1VHcKIN EY 111 Monument Circle,Suite 2700
& E W ANS LLP I n v o i c e Indianapolis, Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
Page 2
September 19, 2012
Invoice No. 554448
* * * * * * * * * * * * * * * * * ATTORNEY SUMMARY * * * * *
Billed Hours Bill
Per Hour Worked Amount
B. Babb 315.00 .30 94 .50
TOTALS .30 94 .50
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
Bose McKinney & Evans
Purchase Order No.
111 Monument Circle, Suite 2700
Terms
Indianapolis, Indiana 46204 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11-12-12 554448 Legal services rendered to the City of Carmel Indiana, ftq4 So
per the attached Invoice
Total $94.50
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
Bose M .LliRRey St_ EvaRS IN SUM OF $
111 Monument Circle, Suite 2700
Indianapolis, Indiana 46204
$ $94.50
ON ACCOUNT OF APPROPRIATION FOR
Department of Law 1180
430-40000 Legal Fees
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
1180 554448 $94.50 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
nature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
B®SE MAIL REMITTANCES TO:
McilAl NEY 111 Monument Circle,Suite 2700
& EVANS LLP I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
ATTN: Douglas C. Haney September 19, 2012
One Civic Square Invoice No. 554447
Carmel, IN 46032 Fed. I .D. 35-0957980
10-29-12P06 �02 R
CO
For Legal Services in Connection With:
Matter: 008824-0015 General Review and Preparation of Contracts,
Easements and Related Documents
08/06/12 B. Babb 0 .3 94 .50 Assemble settlement
agreement signed by D.
Haney, with numbered
exhibits, and forward same
to Citizens vial email;
conference with Citizens
contact regarding same to
refresh her memory on their
offer.
08/31/12 B. Babb 0 .8 252 .00 Attention to: continue
engaging in post-mediation
discussion to coordinate
settlement; conference with
D. Haney regarding same.
Total for Services $346.50
Total This Invoice $346.50
BOSE MAIL REMITTANCES TO:
McKI NE $ 111 Monument Circle,Suite 2700
& EVANS LLP I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
Page 2
September 19, 2012
Invoice No. 554447
OUTSTANDING INVOICES:
DATE NUMBER AMOUNT CREDITS BALANCE
08/13/12 551253 $63 .00 $.00 $63 .00
Prior Outstanding Balance $63 .00
Total Balance Due $409.50
* * * * * * * * * * * * * * * * * ATTORNEY SUMMARY * * * * * * * * * * * * * * *
Billed Hours Bill
Per Hour Worked Amount
-------- ------- ---------
B. Babb 315.00 1.10 346 .50
TOTALS 1.10 346 .50
INDIANA RETAIL TAX EXEMPT PAGE
Ciq o Carmel CERTIFICATE NO.003120155 002 0 11 PURCHASE ORDER NUMBER
� �rri2T "a J � ,"dl FEDERAL EXCISE TAX EXEMPT !� c^ ,_Q i
/`�-G 35-60000972 i.�C_,.J
ONE CIVIC^SQUARE _ THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
t1 elf 1.��/ „�✓
s i
, /'
VENDOR f ,/' i'f+ ✓9 SHIP
%` �° r Y / TO
w �i� !' r'� r" !L / {, a..�� /�f�fr
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE 7 �r DESCRIPTION t / UNIT PRICE EXTENSION
e el
4 �
'o
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
f sit PAYMENT {• *_�0
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE i _ ,{1 .. r%i1•t!IJ..l,/
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. J /
25 CLERK-TREASURER j
DOCUMENT CONTROL NO. A.P. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.-__-_--,---_-,-WARRANT
ALLOWED 20
r ,Q
IN THE SUM OF$
s6)
or 9
ter « v
CCOUNT OF PPROPRIATION FOR
30 -
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
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.. - .... -- - - --_ _ --- ----
i
................................-------------
9
Cost distribution ledger classification if
claim paid motor vehicle highway fund
MEMORANDUM
TO: John Duffy, Director of Carmel Utilities
FROM: Douglas C. Haney, City Attorn
RE: Bose McKinney& Evans Invoice . 554450
Lowe's Home Centers, Inc. /Appropriation of Real Estate
DATE: November 12, 2012
John,
Attached is Bose McKinney & Evan's Invoice No. 554450 in the amount of $306.00 regarding
Lowe's Home Centers, Inc. / Appropriation of Real Estate. Please prepare a purchase order to Bose
McKinney& Evans in the amount of$306.00 in payment of this invoice as a necessary expense.
Please let me know PROMPTLY if you believe that your Department is not responsible for the
payment of the attached invoice or if you have any questions regarding this memorandum.
Thanks.
/eb
Attachment Tff
[eb:n s ord:z:\e bassVny documents\outsidecounsel\bosemckinneyV• I estate\lower home centers\lower H55"50 utilitimdoc:l 1112/121
ROSE MAIL REMITTANCES TO:
McKINNEY I I I Monument Circle,Suite 2700
& EVANS LLP I n v o i c e Indianapolis, Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
ATTN: Douglas C. Haney September 19, 2012
One Civic Square Invoice No. 554450
Carmel, IN 46032 Fed. F.D. 35-0957980
10-29-12P06 : 04 RC D
For Legal Services in Connection With:
Matter: 008824-0147 adv. Lowe' s Home Centers, Inc. / Appropriation
of Real Estate
08/09/12 A. Townsend 0 .1 34 . 00 Review the correspondence
as received from Tammy
Haney regarding the
revisions to the water line
agreement.
08/10/12 A. Townsend 0 .1 34 .00 Correspondence to and from
Tammy Haney regarding the
water line easement with
attention to the
compensation.
08/15/12 A. Townsend 0 .5 17C .00 Review the correspondence
as received from Zeff Weiss
regarding the water line
easement agreement;
telephone conference with
John Duffy regarding the
same; correspondence to
John Duffy regarding the
water line easement
agreement.
08/17/12 A. Townsend 0 .2 68 .00 Correspondence to and from
Zeff Weiss regarding the
water line agreement;
correspondence to and from
Tammy Haney regarding the
same.
Total for Services $306.00
rot:al This Invoice $306.00
�B�OSE MAIL REMITTANCES TO:
-iVYCi1INNE` Y 111 Monument Circle,Suite 2700
E W A \S LLP I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
Page 2
September 19, 2012
Invoice No. 554450
OUTSTANDING INVOICES:
DATE NUMBER AMOUNT CREDITS BALANCE
08/13/12 551256 $170.00 $ .00 $170 .00
Prior Outstanding Balance $170 .00
Total Balance Due $476.00
* * * * * * * * * * * * * * * * * ATTORNEY SUMMARY * * * * * * * * * * * * * * *
Billed Hours Bill
Per Hour Worked Amount
A. Townsend 340 .00 .90 306 .00
TOTALS .90 306 .00
I
BOSE MAIL REMITTANCES TO:
;IWKINNEY T I I1 Monument Circle,Suite 2700
& EVANS LIT I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
Page 3
September 19, 2012
Invoice No. 554450
REMITTANCE COPY
Matter: 008824--0147 adv. Lowe' s Home Centers, Inc. / Appropriation
of Real Estate
OUTSTANDING INVOICES:
DATE NUMBER AMOUNT CREDITS BALANCE
08/13/12 551256 $170 . 00 $ .00 $170 . 00
Prior Outstanding Invoices $170 .00
Total Due Invoice 554450 $306 .00
Total Balance Due Upon Receipt $476.00
PLEASE SEND WITH CHECK TO:
BOSE MCKINNEY & EVANS LLP
111 MONUMENT CIRCLE, SUITE 2700
INDIANAPOLIS, IN 46204
Please call (317) 684-5140 with any questions..
THANK YOU FOR CHOOSING BOSE McKINNEY & EVANS!
WE APPRECIATE THE OPPORTUNITY TO SERVE YOU.
I
VOUCHER # 122818 WARRANT # ALLOWED
27235 IN SUM OF $
BOSE MCKINNEY & EVANS LLP
2700 First Indiana Plaza
135 North Pennsylvania
Indianapolis, IN 46204
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
554450 06-1050-22 $306.00
Availability
�Plo
Voucher Total $306.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
27235
BOSE MCKINNEY& EVANS LLP Purchase Order No.
2700 First Indiana Plaza Terms
135 North Pennsylvania Due Date 11/19/2012
Indianapolis, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/19/201; 554450 $306.00
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
Date Officer
MEMORANDUM
TO: John Duffy, Director of Carmel Utilities
FROM: Douglas C. Haney, City Attorn�
RE: Bose McKinney& Evans Invoice No. 555129
Lowe's Home Centers, Inc. /Appropriation of Real Estate
DATE: November 12, 2012
John,
Attached is Bose McKinney & Evan's Invoice No. 555129 in the amount of $170.00 regarding
Lowe's Home Centers, Inc. / Appropriation of Real Estate. Please prepare a purchase order to Bose
McKinney& Evans in the amount of$170.00 in payment of this invoice as a necessary expense.
Please let me know PROMPTLY if you believe that your Department is not responsible for the
payment of the attached invoice or if you have any questions regarding this memorandum.
Thanks.
/eb
Attachment
[eb:mswordz:\e bass\my documents\outsidecounsel\bosemckinney\real estate\lo—home centers\to—8555129 ubhtimdoc:l 1/12/12]
�B®SE MAIL REMITTANCES TO:
1V1cK1IrNEY 111 Monument Circle,Suite 2700
& EVANS LLP I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
ATTN: Douglas C. Haney October 5, 2012
One Civic Square Invoice No. 555129
Carmel, IN 46032 Fed. I.D. 35-0957980
10-29-12P05 :47 RCVD
For Legal Services in Connection With:
Matter: 008824-0147 adv. Lowe' s Home Centers, Inc. / Appropriation
of Real Estate
09/04/12 A. Townsend 0 .1 34 .00 Correspondence to and from
John Duffy regarding the
water line easement and the
settlement check.
09/19/12 A. Townsend 0 .4 136 .00 Correspondence to and from
Zeff Weiss regarding the
settlement check; telephone
conference with Trent
Newport regarding the water
line easement;
correspondence to Trent
Newport regarding the same.
Total for Services $170 .00
Total This Invoice $170.00
OUTSTANDING INVOICES:
DATE NUMBER AMOUNT CREDITS BALANCE
09/19/12 554450 $306 .00 $.00 $306.00
Prior Outstanding Balance $306 .00
Total Balance Due $476.00
�BOSE MAIL REMITTANCES TO:
1VgCKI NE 111 Monument Circle,Suite 2700
& Ei VANS LLP I n v o i c e Indianapolis,Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
Page 2
October 5, 2012
Invoice No. 555129
* * * * * * * * * * * * * * * * * ATTORNEY SUMMARY * * * * * * * * * * * * * * *
Billed Hours Bill
Per Hour Worked Amount
A. Townsend 340.00 .50 170 .00
TOTALS .50 170 .00
VOUCHER # 122819 WARRANT # ALLOWED
27235 IN SUM OF $
BOSE MCKINNEY & EVANS LLP
2700 First Indiana Plaza
135 North Pennsylvania
Indianapolis, IN 46204
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
555129 06-1050-22 $170.00
Availability
Voucher Total $170.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
27235
BOSE MCKINNEY& EVANS LLP Purchase Order No.
2700 First Indiana Plaza Terms
135 North Pennsylvania Due Date 11/19/2012
Indianapolis, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/19/201: 555129 $170.00
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
ldv/
Date icer
B®SE MAIL REMITTANCES TO:
McKINNEY I I I Monument Circle,Suite 2700
& EVANS LLP I n v o i c e Indianapolis. Indiana 46204
(317)684-5000
ATTORNEYS AT LAW
008824 City of Carmel
ATTN: Douglas C. Haney October 5, 2012
One Civic Square Invoice No. 555127
Carmel, IN 46032 Fed. I.D. 35-0957980
10-29-12P05 :41 RCVD
For Legal Services in Connection With:
Matter: 008824-0015 General Review and Preparation of Contracts,
Easements and Related Documents
09/07/12 J. Hamilton 0 .1 34.00 Phone call with Doug Haney
regarding health clinic.
09/10/12 J. Hamilton 0.3 102 .00 Phone call with Barb Lamb
regarding interaction of
clinics and HSAs; email to
Barb Lamb regarding same.
09/12/12 J. Hamilton 3 .4 1, 156 .00 Review of HSA guidance;
drafting of memo to Barb
Lamb.
09/13/12 D. Meyer 1.2 516.00 Review, research and revise
memorandum regarding
on-site clinics that
provide significant medical
services to HSA eligible
participants.
09/14/12 J. Hamilton 0.3 102 .00 Review of clinic memo;
transmittal to Barb Lamb.
09/19/12 B. Babb 3 .1 976 .50 Attention to: continue
engaging in post-mediation
discussion to coordinate
settlement; conference with
Mayor regarding same.
Total for Services $2, 886.50
Total This Invoice $2, 886.50
INDIANA RETAIL TAX EXEMPT PAGE
City o Carmel CERTIFICATE NO.003120155 002 0 Jl PURCHASE ORDER NUMBER
7 _ 1 FEDERAL EXCISE TAX EXEMPT f
�.`L 35-60000972 a�-
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO.' ' DESCRIPTION
4
VENDOR ' ''`cif ��✓�'!T j f t�' - °''�Ir'd' �r SHIP
[ TO
CONFIRMATION BLANKET CONTRACT j PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE �DESCRIPTION / UNIT PRICE EXTENSION
Na,
. r�:....i/�f'S,l�� r�../-_�'�R,�.'"�r'�"�,� ,�/U{:��-°9✓�t/.v�i rr I �. 5...y7 /^
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r 4
t 0 4
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT � rC�
•1 ✓ j �'"'1 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HA&THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. f
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE `_ ��.rL-f �I.+`( / G'i"i�r•�.-'f
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. •a (`
2 5 2*92- 2 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON CCOUN�JR+Pl IONFR
t
Board Members
PO#or INVOICE NO, ACCT#/TITLE AMOUNT
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
'� %•JU materials or services itemized thereon for -
which charge is made were ordered and
received except-...-_.....
_-__
ture
_...............-----.....-_......_............._...................... ....-...._-.........._.- . _.
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund