223420 08/27/2013 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
M;oN co CARMEL IN 46032 CHECK NUMBER: 223420
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4350900 10716 90 . 00 OTHER CONT SERVICES
MAKE CHECK PAYABLE TO INVOICE
®ICE
Carmel Drive Self-Storage
550 W.Carmel Dr
Carmel,IN 46032 Unit J201
317-574-1700 Tenant 52903
Invoice 10716
Invoice Date August 07,2013
Due Date September 01,2013
Amount Due 90.00
CITY OF CARMEL _
c/o: DIANA L CORDRAY �_� 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 ITEW SERVICE AMOUNT TAX DUE
J201 9/1/2013 Rent 9/1-9/30 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.
Carmel Drive Self-Storage
550 W. Carmel Dr
Carmel, IN 46032-0000
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CITY OF CARMEL
ONE CIVIC SQUARE
CARMEL, IN 46032-2584
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.
`11�
�1.1 urchase 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 $
W V Cl�l 1Y
ON ACCOUNT OF APPROPRIATION FOR
U*1 V V�(w OvL4
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
1 10-71(p Q 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
A.
. a
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund