222112 07/17/2013 a CITY OF CARMEL, INDIANA VENDOR: 358229 Page 1 of 1
ONE CIVIC SQUARE NICOLE PASSINEAU
CARMEL, INDIANA 46032 ci CHECK AMOUNT: $159.99
C/O oocs
CHECK NUMBER: 222112
CHECK DATE: 7/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4239012 159 . 99 SAFETY SUPPLIES
Thank you Tor shopping at Merrell Carmel
Merrell Carmel
14405 Clay Terrace Blvd.
Suite 130
Carmel, IN 46032
317-573-0065
7/10/2013 05:38 PM 1001/23/38368
3176453479
NICHOLE PASSINEAU
Regular Sale
MOAB VENT MID WTPF, in BUNGEE CORD
J88790 9 M 1 120.00
FULL LENGTH ARCH SUP
PINNACLE M-6/W-8 1 39.99
Subt tal: 159.99
T
3
Items Sold: 2
Returns only within 30 days.
Merchandise must be in original
condition.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Nichole Passineau
IN SUM OF $
c/o One Civic Square
Carmel, IN 46032
I
i
$159.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1192 I 1001/23/38368 I 42-390.12 I $159.99 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
Thursday, July 11, 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))
07/10/13 1001/23/38368 safety boots $159.99
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