222973 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 354402 Page 1 of 1
`4 ONE CIVIC SQUARE DAVID HABOUSH
CARMEL, INDIANA 46032 1942 TROW13RIDGE HIGH STREET CHECK AMOUNT: $10.49
CARMEL IN 46032
CHECK NUMBER: 222973
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 10 . 49 OTHER EXPENSES
CVS/pharrviacy"
1421 S. RANGE LINE RD, CARMEL, IN
(317) 844-2775
REG#02 TRN#8821 CSHR#1043296 STR#8674
Helped bq: SASHA
1 CUS SUN LOTION 30 16Z 10.49-1
SUBTOTAL 10.49
IN 7.0% TAX .73
-TOTA1 11.22
11.22
* * * * MS
CHANGE .00
Iliilil 111 llll illiiilllll llli!! l ill
2508 6743 2048 8210 20
RETURNS WITH RECEIPT THRU 09/21/2013
JULY 23, 2013 10:47 AM
GET YOUR CUS EXTRACARE CARD
THANK YOU. OPEN 21 HOURS 7 I1(?YS A MEEK
VOUCHER NO. WARRANT NO.
ALLOWED 20
Dave Haboush
IN SUM OF $
$10.49
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 1 120-851.00 j $10.49 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
AUG 12 2013
Fire Chief
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))
$10.49
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