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223148 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1 ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF COL�g CARMEL, INDIANA 46032 C/O PAM LISTER CHECK AMOUNT: $20.17 CHECK NUMBER: 223148 tirti�ia CHECK DATE: 8113/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 20 . 17 FOOD & BEVERAGES 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)) 07/28/13 O'Malia Bread $4.00 07/29/13 Marsh Food $5.67 07/29/13 Kroger Food $3.00 07/29/13 Entenmanns Bread $7.50 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 Petty Cash IN SUM OF $ $20.17 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 O'Malia 42-390.40 $4.00 1 hereby certify that the attached invoice(s), or 1207 Marsh 42-390.40 $5.67 bill(s) is (are) true and correct and that the 1207 Kroger 42-390.40 $3.00 materials or services itemized thereon for 1207 Entenmanns 42-390.40 $7.50 which charge is made were ordered and received except Monday, August 05, 2013 Director, Brookshir Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund