219700 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 00353420 Page 1 of 1
±� ONE CIVIC SQUARE GEORGE W DAVIS
CARMEL, INDIANA 46032 3854 CORNWALLIS LANE CHECK AMOUNT: $23.73
CARMEL IN 46032 CHECK NUMBER: 219700
CHECK DATE: 517/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343003 23 . 73 TRAVEL & LODGING
1 ,
liar & Restaurant
160 E. Carmel Dr,
Carmel, IN 46032
(317) 843-9900
Date: Apr29'13 12:34PM
Card Type: Visa -
Acct #: XXXXXXXXXXXX3301
Card Entry: SWIPED
Trans Type: PURCHASE
Trans Key: AIA009048398615
Auth Code: 03277B
Check: 2321
Table: D4/1
Server: 116 Zylar W
Subtotal : 19 . 7 3
TIP:
TOTAL: -
CUSTO COP.
vV �"
TH U
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))
04/29/13 history project $23.73
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
George W. Davis
IN SUM OF $
3854 Cornwallis Lane
Carmel, IN 46032
$23.73
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 43-430.03 $23.73
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
Wednesday, May 01,2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund