215923 01/07/2013 CITY OF CARMEL, INDIANA VENDOR: ,Q ��, �,�n ��;,n ,�,� � age 1 of 1
ONE CIVIC SQUARE TI(L I U I l PLC,W F 22
CARMEL, INDIANA 46032 CHECK AMOUN : L e,7
CHECK NUMBER: 2159;3
CHECK DATE: d-0/213:
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
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REMITTANCE ADVICE-DETACH AND RETAIN FOR YOUR RECORDS °----
Hamilton County Recorder
Mary L. Clark
01/07/2013 10:46:28A Trans 0: 000476064
Business Date: 01/07/2013 Rec By: PSI
2013801128 RIGHT WAY 10:46:28A
Subtotal: $19.00
2013001129 RIGHT WAY 10:46:28A
Subtotal: $25.00
2013001130 RIGHT WAY 10:46:28A
Subtotal: $18.00
2013001131 ORDINANCE 10:46:28A
Subtotal: $35.00
2013001132 ORDINANCE 10:46:28A
Subtotal: $40.00
Receipt Total: $137.00
Paid By Amount Ref N
Check $137.00 0000005923
CITY OF CARMEL
Rcvd From: CITY OF CARMEL
Good Day Sunshine!
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
dtPurchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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 APPROPRIATION FOR
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
'h
Signatu
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund