216930 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 360212 Page 1 of 1
ONE CIVIC SQUARE MATT WORTHLEY
, +o CARMEL, INDIANA 46032 14383 GEORGE COURT CHECK AMOUNT: $229.00
CARMEL IN 46032 CHECK NUMBER: 216930
CHECK DATE: 1129/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1801 4350900 229. 00 RECORDING FEES
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.352
RECEIPT
HAMILTON COUNTY AUDITOR 0849
FUND
NOBLESVILLE, IN, I !?L 20
RECEIVED FROM
"aLff-_
THE SUM OF DOLLARS
100
ON ACCOUNT OF ildfiVL�a�f �
PAID BY: ASH ❑CHECK ❑M.O.
AUTHORIZED SIGNATURE
Hamilton County Recorder
Mary L. Clark
01/18/2013 03:13:10P Trans #: 000479326
Business Irate: 01/18/2013 Rec By: LLP
2013004074 WARR DEED 03:13:10P
Subtotal: 826.00
2013004075 RELEASE 03:13:10P
Subtotal: 814.00
2013004076 WARR DEED 03:13:10P
Subtotal: 820.00
2013004077 WARR DEED 03:13:10P
Subtotal: 856.00
2013004078 WARR DEED 03:13:10P
Subtotal: 858.00
Receipt Total: 8174.00
Paid By Amount Ref #
CreditCard 8174.00
MATT WORTHLEY
Rcvd From: MATT WORTHLEY
A convenience fee of 86.00 will
be applied.
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.
f `./ Payee.
M I I W r leg Purchase Order No.
571 ��th SI, IV�1 Terms
Carmel, lJV ��032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
r i r t or +-gn_4tr krA ►n )/I -Fee SS.
rclMLjrscate4 lor re(orqjhj of 4e_ fee
Total 22 I a6
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and 1 have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
/ ALLOWED 20
MAW ►N of ley IN SUM OF $
5711 llfh AIW
C6rmef , =T M g663�
$ z2 I",
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or
DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s),
1801 0941 4550160 55,14 or bill(s) is (are) true and correct and that
(fib I 4-79 326 4350106 17 t UU the materials or services itemized thereon
for which charge is made were ordered and
received except
1—Zy— 20(3
Signature
Executive Director
Cost distribution ledger classification if Title
Carmel Redevelopment Commission
claim paid motor vehicle highway fund