220887 06/17/2013 CITY OF CARMEL, INDIANA VENDOR: 358340 Page 1 of 2
ONE CIVIC SQUARE A T&T LONG DISTANCE CHECK AMOUNT: $66.78
` ,CARMEL INDIANA 46032
PO BOX 5017
CAROL STREAM IL 60197-5017 CHECK NUMBER: 220887
CHECK DATE: 6/1712013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4344000 839002612 17 . 50 TELEPHONE LINE CHARGE
1115 4344000 839002612 1 . 12 TELEPHONE LINE CHARGE
1120 4344000 839002612 7 . 86 TELEPHONE LINE CHARGE
1160 4344000 839002612 1 .45 TELEPHONE LINE CHARGE
1180 4344000 839002612 2 . 87 TELEPHONE LINE CHARGE
1192 4344000 839002612 6 . 09 TELEPHONE LINE CHARGE
1203 4344000 839002612 . 13 TELEPHONE LINE CHARGE
1205 4344000 839002612 2 . 30 TELEPHONE LINE CHARGE
1301 4344000 839002612 . 36 TELEPHONE LINE CHARGE
1701 4344000 839002612 2 . 94 TELEPHONE LINE CHARGE
2200 4344000 839002612 2 . 16 TELEPHONE LINE CHARGE
2201 4344000 839002612 . 02 TELEPHONE LINE CHARGE
601 5023990 839002612 6 . 59 OTHER EXPENSES
CITY OF CARMEL, INDIANA VENDOR: 358340 Page 2 of 2
ONE CIVIC SQUARE A T&T LONG DISTANCE
o CARMEL, INDIANA 46032 PO Box 5017 CHECK AMOUNT: $66.78
CAROL STREAM IL 60197-5017 CHECK NUMBER: 220887
CHECK DATE: 6/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 839002612 14 . 76 OTHER EXPENSES
902 4344000 839002612 . 63 TELEPHONE LINE CHARGE
This is a summary of the ATT Long Distance billing for: 61112013
DEPARTMENT TOTAL
Administration $1.41
CCCC $1.1
Clerk Treasurer $2.94
Community Relations $0.13
Court $0.36
CRC $0.27
DOCS $6.09
Drugs Task Force $0.36
Engineering $2.16
Fire $7.86
IS $0.89
Law $2.87
Mayor $1.45
Police $17.50
Sewer $13.11
Sewer Dist $0.32
Street $0.02
Utilities $2.65
Water $5.23
Water Dist $0.04
Grand Total $66.78
Tuesday,June 11,2013 Page 1 of 1
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Farm 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 �f
y l � � Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Lb
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.
7 `� q ALLOWED 20
l s I w ��� �� cc-- IN SUM OF $
(A,[ 6 101
$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
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
t,.
SignatLbf
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
AT&T Long Distance
IN SUM OF $
P. O. Box 5017
Carol Stream, IL 60197-5017
$1.45
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1160 Statement 43-440.00 $1.45 I hereby certify that the attached invoice(s), or
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
Friday, June 14, 2013
Mayor
Title '
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/01/13 Statement $1.45
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
AT&T Long Distance
IN SUM OF $
P.O. Box 5017
Carol Stream, IL 60197-5017
$2.30
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1205 06.01.13 43-440.00 $0.89 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1205 06.01.13 43-440.00 $1.41
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, June 17, 2013
Director, Administrat' n
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/01/13 06.01.13 IS $0.89
06/01/13 06.01.13 Admin $1.41
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
AT & T Long Distance
IN SUM OF $
P.O. Box 5017
Carol Stream, IL 60197-5017
$6.09
ON ACCOUNT OF APPROPRIATION FOR'
Carmel DOCS
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1192 43-440.00 $6.09
I hereby certify that the attached invoice(s), or
I 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
Friday, June 14, 2013
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/11/13 $6.09
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
Prescribed by State Board of Accounts
Form No.301(Rev.1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I hereby certify that the attached invoice(s), or 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
' 19
Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (are)true a correct and 1 have audited same in accordance
with IC 5-11-10-1.6.
19
(Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
NO,
CARMEL, INDIANA
Favor Of
40115 �11,5 tv P
Total Amount of Voucher $
I
Deductions
S-7112 6
0 6 540-6,0,
Amount of Warrant $ 32
Month of 19
VOUCHER RECORD Acct.
No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies i
Customers Deposits
Total
M1
Allowed
I
Board of Control
I
Filed
1
Official Title I
BOYCE FORMS•SYSTEMS 1-800-3828702 325
VOUCHER # 135759 WARRANT # ALLOWED
356463 IN SUM OF $
AT & T LONG DISTANCE
PO BOX 5017
Carol Stream, IL 60197-5017
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
3175712634 01-7362-05 $13.11
3i�5�>a�y5 OI.736o-oa o.30�
13•`��
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
356463
AT &T LONG DISTANCE Purchase Order No.
PO BOX 5017 Terms
Carol Stream, IL 60197-5017 Due Date 6/12/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/12/2013 3175712634 $13.11
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
Date Officer
Prescribed by Accounts ACCOUNTS PAYABLE VOUCHER
Form No.301-S(Rev.1995)
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I hereby certify that the attached invoice(s), or 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
, 19
Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (are)true and c rrect and I have audited same in accordance
with IC 5-11-10-1.6.
19
O icer Title
J
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
SANITATION DEPARTMENT ACCT.
CARMEL, INDIANA No.
avor Of
14-Fir
r r
Total Amount of Voucher $
Deductions
0 3
Amount of.Warrant $
Month of 19
VOUCHER RECORD Not
Collection System
Operation
Plant
Commercial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts-Merchandise
Total
Allowed
Board Members
Filed
BOYCE FORMS•SYSTEMS 1-800-3828702 325
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
ATT Long Distance Purchase Order No.
POB 5017 Terms
Carol Stream, IL 60197-5017 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
6/1/2013 0 long distance charges $ 2.16
Total $ 2.16
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 NC WARRANT NO.
ATT Long Distance ALLOWED 20
POB 5017 IN SUM OF$
Carol Stream, IL 60197-5017
$ 2.16
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
DEPT# I hereby certify that the attached invoice(s),
0 0 2200-4344000 $ 2.16 or 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
/L 6/17/2013
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund
VOUCHER # 131876 WARRANT # ALLOWED
356463 IN SUM OF $
AT & T LONG DISTANCE
PO BOX 660688
DALLAS, TX 75266-0688
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
5712255 01-6360-03 $5.23
5-71 Z2-5':!s It
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
356463
AT& T LONG DISTANCE Purchase Order No.
PO BOX 660688 Terms
DALLAS, TX 75266-0688 Due Date 6/1312013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6113/2013 5712255 $5.23
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 Wo
Date r
VOUCHER NO. WARRANT NO.
ALLOWED 20
AT&T Long Distance
IN SUM OF $
P.O. Box 5017
Carol Stream, IL 60197-5017
$1.12
ON ACCOUNT OF APPROPRIATION FOR
Carmel ClaV Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1115 I I 43-440.00 I $1.12 1 hereby certify that the attached invoice(s), or
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
Tueday, June 11, 2013
P'
� Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/01/13 I I I $1.12
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
AT&T Long Distance
IN SUM OF $
P. O. Box 5017
Carol Stream, IL 60197-5017
$0.13
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1203 Statement 43-440.00 $0.13
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
Monday,June 17, 2013
.,emu
Director, Community R lations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/01/13 Statement $0.13
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
AT & T Long Distance
IN SUM OF $
P.O. Box 5017
Carol Stream, IL 60197-5017
$0.36
ON ACCOUNT OF APPROPRIATION FOR
Project 2013-911 Task 2013-2
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
911 43-440.00 $0.36
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
Monday, June 17, 2013
0-0"
Major
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/01/13 $0.36
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.
AT & T ALLOWED 20
IN SUM OF $
P.O. Box 8100
Aurora„ IL 60507-8100
$17.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 43-440.00 $17.50
I hereby certify that the attached invoice(s), or
I 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
Friday, June 14, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/01/13 monthly payment $17.50
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
A T & T Long Distance
IN SUM OF $
P. O. Box 5017
Carol Stream, IL 60197-5017
$0.02
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
T
2201 I I 43-440.00 $0.02 1 hereby certify that the attached invoice(s), or
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
day J 3
SS#etC61P M�981TWr
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/12/13 $0.02
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
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
bis f'qN C_t__Q Purchase Order No.
0 ��X sd 17 Terms
o/9 7 Date Due
Invoice Invoice Description Amount
at Number (or note attached invoice(s) or bill(s))
Total 3
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.
r
T— �`�� ALLOWED 20
C-E
IN SUM OF $
PO j�/Y �'� 7
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INV ICE NO. ACCT#/TITLE AMOUNT
DEPT.# / I hereby certify that the attached invoice(s), or
�_ 3 3L/ d 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
i
t��' i
Cost distribution ledger classification if 'Tile
claim paid motor vehicle highway fund
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
AT&T Long Distance
Purchase Order No.
P. O. Box 5017 •
Terms
Carol Stream, IL 60197-5017 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6-21-13 Telephone Long Distance Charges per the attached $2.87
Statement 6/1/2013
1`
•
Total $2.87
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
AT&T I ONG DISTANCF IN SUM OF $
P.O. Box 5017
Carol Stream, IL 60197-5017
$ $2.87
ON ACCOUNT OF APPROPRIATION FOR
DEPARTMENT OF LAW 1180
430-44000 Telephone Line Charges
Board Members
DEPT.# INVOICE NO. ACCT#!TITLE AMOUNT I hereby certify that the attached invoice(s), or
1180 6/1/2013 Bill $2.87 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
•;I��,r LAWI - received except
20 L3
T
_/i.nature
Cost distribution ledger classification if Tltl;
claim paid motor vehicle highway fund
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.
11- I/ /�Pay(ee
o kit(8C? Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6-I-13 601/3 (R6 10119 di5lb4i° f'hyiP 5eri4'e 017
Total Q_27
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
4-757- Lam, kiwe IN SUM OF $
0. 2 7
ON ACCOUNT OF APPROPRIATION FOR
`
1)4frieoll f3000
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT hereby certify invoice(s),DEPT.# I hereb certif that the attached invoices , or
4010 43414000 0.27 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
7- I - 2013
Ignature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund