217664 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1
0 ONE CIVIC SQUARE DOUGLAS HANEY
CARMEL, INDIANA 46032 C/O DEPT OF LAW CHECK AMOUNT: $74.99
C/O DEPT OF LAW CHECK NUMBER: 217664
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4463100 74 . 99 COMMUNICATION EQUIPME
EQUIPMENT RECEIPT
VERIZON WIRELESS
1950 'E Greyhound Pass
Carmel, IN 46033-7730"
(317)580-9548
verizonwireless.com
--Order Location: - M4912 01 #223385
Receive Location: M4912 01
Receipt Date/Time: 01/31/2013 10:33 ET
Ra?ister: 01 thom7ch - EUA45
1E'm 1of1
i ,
Retail Your
Price Price
-- -------------------------------
HBL:IPAD2 ZA $99.99 $74.99
ZAGGIPAD2BTF
----------------------------------------
----------------------------------------
Total Taxes Fees: $0.00
TTotal : $74.99
Total Savings: $25.00
This Payment: $74.99
Payment Method: XXXXXXXXXXOA
Signature:
------------------------------------------
Customer Recycling Disclosure
-----------------------------------------
Electronic waste should be recycled or
disposed of properly, Contact
"http://www.in.gov/recycle/" or call
800-988-7901 .
-----------------------------------------
Return Policy
-----------------------------------------
New and Certified Pre-Owned merchandise
items may only be returned or exchanged
within 14 days (02/14/2013), You' are
permitted to make one exchange,
See vzw.com/returnpolicy for
complete details.
Thank You!
M 11 S M.4 12-01000220065
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
Douglas C. Haney
Purchase Order No.
13828 Smokey Ridge Drive
Terms
Carmel, Indiana 46033
Date Due
Invoice Invoice _ Description Amount
Date Number (or note attached invoice(s) or bill(s))
2-12-13 Reimburse Douglas C. Haney for monies he personally $74.99
expended to purchase ZagglPad2B per the attached
rF
Total
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 NO. WARRANT NO.
ALLOWED 20
Douglas G. Hapey IN SUM OF $
13828 Smokey Ridge Drive
Carmel, Indiana 46033
$ $74.99
ON ACCOUNT OF APPROPRIATION FOR
Department of Law 1180
440-63100 Communications Equipment
Board Members
DEPT INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1180 $74.99 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
re
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund