219433 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 00352791 Page 1 of 1
` ONE CIVIC SQUARE JASON OGLE
CARMEL, INDIANA 46032 3860 MADELINE LANE CHECK AMOUNT: $19.01
CARMEL IN 46033 CHECK NUMBER: 219433
CHECK DATE: 4124/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 19 . 01 GASOLINE
SPEEDWAY
8883352
Fishers
IN 46838-4551
43177773-5639
rRAN# : -3732512
Pump 12
Unleaded, Self Serve
5 . 883 @ $3 . 739/GAL
GAS TOTAL $19 . 81 _-
rAX $0 . 88
TOTAL19 . e1
Raster Card
Gard Num' :
iiXXXXXXXXXXX7381
TERM :
9858883352881
IPPR# : 04215Z
5EQ# : 893821196
94/83/2813 18 : 51 : 38
Cardholder agrees to
Pay to issuer total ,
Charges per the
agreement between
cardholder & issuer . a
VISIT US . AT
WWW . SPEEDWAY . COM
CUSTOMER SERVICE
1-888-643-1948
4-F 8 : 38A-5 : 38P EST'
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/03/13 gasoline/transport new prisoner van $19.01
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
Jason W. Ogle
IN SUM OF $
3860 Madeline Lane
Carmel, IN 46033
$19.01
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 42-314.00 $19.01
I hereby certify that the attached invoice(s), or
I
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
Thursday, April 18, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund