214617 11/20/2012 CITY OF CARMEL, INDIANA VENDOR:, 00352128 Page 1 of 1
ONE CIVIC SQUARE CHARLES E DRIVER
CARMEL, INDIANA 46032
CHECK NUMBER: 214617
OM
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 43 . 38 GASOLINE
WELCOME TO
CIRCLE K
57 444808208
�2 S1D0522
Descr. qty amount
<CUSTOMER COPY>
E-85 CA #10 13.4356 43.38
SELF @ 3.229/ G
Sub Total 43.38
Tax 0.00
TOTAL 43 . 38
CREDIT $ 43.38
XXXX XXXX XXXX
ODOMETER: 456
INVOICE: 897827 AUTH #: 86,5230
THANKS COME AGAIN
REG# 0003 CS4,008 OR# 01 TRAN# 39838
11/09/12 22:27:01 ST# 2368
VOUCHER NO. WARRANT NO.
ALLOWED 20
Charles Driver
IN SUM OF $
$43.38
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO##/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1,110 42-314.00 $43.38
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
Th say, November 15, 2012
Chief of Police
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))
11/09/12 gasoline $43.38
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