220853 06/06/2013 CITY OF CARMEL, INDIANA VENDOR: 367202 Page 1 of 1
ONE CIVIC SQUARE CARMEL DRIVE SELF-STORAGE
CHECK AMOUNT: $90.00
CARMEL, INDIANA 46032 550 W CARMEL DRIVE
tr° CARMEL IN 46032 CHECK NUMBER: 220853
CHECK DATE: 616/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4341999 J201 6/13 90 . 00 OTHER PROFESSIONAL FE
_ 4L
MAKE CHE PAYABL O ► ` � IN VOICE
Carmel Drive Self-Storage
550 W. Carmel Dr
Carmel, IN 46032 (j� Unit J201
317-574-1700 x�� Tenant 52903
V Invoice 9753
Invoice Date April 22,2013
Due Date June 01,2013
Amount Due 90.00
CITY OF CARMEL _
c/o: DIANA L CORDRAY 1_1 Please check box if address is incorrect
ONE CIVIC SQUARE and indicate change. Signature is required
CARMEL IN 46032 to authorize address changes.
Signature
AMOUNT ENCLOSED
-------------------------------------------------------------------------------_---------
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
UNIT DATE ITEM/SERVICE AMOUNT TAX DUE
J201 6/1/2013 Rent 6/1-6/30 90.00 0.00 90.00
Subtotal 90.00
Taxes 0.00
Balance Due 90.00
Please remit the total due amount of go.oo to the above address.
REFERRALS PAY OFF! ! ! ! ! Send your friends and collect your bonus.
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
IN SUM OF $
qv
ON ACCOUNT OF APPROPRIATION FOR
Board Members
I f
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
lS 3 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
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund