217336 02/13/2013 ,., CITY OF CARMEL, INDIANA VENDOR: 00350581 Page 1 of 1
!I ONE CIVIC SQUARE PAT RIGDON CHECK AMOUNT: $5.00
�o CARMEL, INDIANA 46032 353 WESTLEA DR
WESTFIELD IN 46074 CHECK NUMBER: 217336
CHECK DATE: 2/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 021113 5 . 00 OTHER EXPENSES
DG I LR EATH 130114134822635
RECEIPT Fund CORPORATE
City of Westfield
130 Penn St Receipt Date 1/14/2013
CITY CJF
Westfield, IN 46074 Receipt No. GJPD10077
We S t f i I d Payment Type Check
WALK IN CUSTOMER Ref No. #1130
INDIANA
Payment Amt $5.00
Payment Applied To:
Internal Rev Acct Rev.Acct.Name Description Quantity Unit Price Total
239542 Police Law Enforcement Report Accident Reports 1 5.00 5.00
Customer Name: Patrick Rigdon
Comments: 13-000084
Approved by State Board of Accounts for City of Westfield,2012
r"
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
350581
PAT RIGDON Purchase Order No.
carmel utilities Terms
Due Date 2/7/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/7/2013 021113 $5.00
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
VOUCHER # 126654 WARRANT # ALLOWED
350581 IN SUM OF $
PAT RIGDON
carmel utilities
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
021113 01-7750-08 $5.00
Voucher Total $5.00
Cost distribution ledger classification if
claim paid under vehicle highway fund