217160 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 00353214 Page 1 of 1
p ONE CIVIC SQUARE DAN GRESKAMP
CARMEL, INDIANA 46032 C/0 ENGINEERING CHECK AMOUNT: $99.99
C/0 ENGINEERING
<.o � CHECK NUMBER: 217160
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4239099 99 . 99 OTHER MISCELLANOUS
Subtotal 99.99
Tax 7.00
Total Inc--�� '
T oR
s O
NYC_
TractbrSupply.com
UT 2375 EAST PLEASANT ST., RT.
NOBLESVILLE, IN 46060
317-776-1883
Ticket; 252273
Date: 1/31/13 Time: 3:49 PM
Store: 624 Register: 2
Cashier: 00229865
Item Qty Price__ Amount
BOOT MENS 9M TAN 6IN
7014335 1 99.99 99,99
Subtotal 99.99
Tax 7,00
Total 106.99
Auth 4:031276
Change 0.00
I agree to Pay the above amount according to
m9 card issuer agreement.
Go to TractorSuPP NSurvea.com or Call
1-877-789-1443 within 7 days to
complete a survey and be entered in
a monthly drawing for a chance to
win a $2500 shopping spree.
(Awarded as Gift Cards) Ends 12/31/2013
For complete details or to r
pa ticipate
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Enter Store 4: 0624
Enter Reference:4: 02252273
SOLD ITEM COUNT = 1
IIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIII III III IIIIIIIIIIIIIIIIIII
T1X141JE7R4ALMR1
Please call 877-872-7721 for Customer
Service.
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Customer Copy
C_<el a.
YvO(K G0()+S
1W rug-IlLoWaTo
without Purchase or survey, so to
TractorSuPPly,com/customersurvey �,� �
Enter Store 4: 0624
Enter Reference 4: 02252273 City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
SOLD ITEM 111111111111111111 IIIIII CITY OF CARMEL
IIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIII�I must show: kind of service, where performed, dates service rendered, by whom,
T1X141JE7R4ALMR1 hour, number of units, price per unit, etc.
Please call 877-872-7721 for Customer
Service.
Purchase Order No.
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Date Due
Customer CoPw
Description
(or note attached invoice(s) or bill(s) Amount
reimbursement $ 106.99
Total $ 106.99
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 NC WARRANT NO.
Dan Greskamp ALLOWED 20
IN SUM OF $
$
ON ACCOUNT OF APPROPRIATION FOR
� J
Board Members
PO#or
,. DEPT# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s),
0 0 2200-4239099 $ 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
� ",g 2/11/2013
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund
�r