224440 09/25/2013 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
CARMEL IN 46032 CHECK NUMBER: 224440
CHECK DATE: 9/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4350900 10966 90 . 00 OTHER CONT SERVICES
MAKE CHECK PAYABLE TO INVOICE
Carmel Drive Self-Storage
550 W.Carmel Dr
Carmel, IN 46032 Unit J201
317-574-1700 Tenant 52903
Invoice 10966
Invoice Date September 05,2013
Due Date October 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 ITEM/SERVICE AMOUNT TAX DUE
J201 101112013 Rent 10/1-10/31 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.
Prescribed by State Board of Accounts City Form No 201(Rev.1995)
ACCOUNTS PAYABLI 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))
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
i
VOUCHER NO. WARRANT NO.
WT- (-I��\ ALLOWED 20
E/ r 4
�'IL IN SUM OF $
$
ON ACCOUNT OF APPROPRIATION FOR
(�Tif-q)q m4-t(-
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
s
r
Signature
Cost distribution ledger classification if Title 7
claim paid motor vehicle highway fund