225788 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 00351756 Page 1 of 1
ONE CIVIC SQUARE JEFFREY W COOPER
CARMEL, INDIANA 46032 C/0 CARMEL WASTEWATER CHECK AMOUNT: $34.00
C/0 CARMEL WASTEWATE CHECK NUMBER: 225788
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 34 . 00 OTHER EXPENSES
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Customer Transaction Receipt
BM W State Form 51717 (4-04)
hib..
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Branch: CARMEL STARS(527) Date: 10119113 Time: 11:50:13 am EDT
Visit ID: 188627204 Your Visit Time Today:
Visit Customer: JEFF W COOPER
Transaction Time 00:07:43
Total time
Hrs.Min.Sec 00:07:43
Transactions
Trans ID (PIN) Trans Tvue Trans Subtype Amount
227519372 Driver- Renew CDL License Renew $35.00
227519613 Customer-Amend Customer Amend $0.00
227519865 Customer-Voter Registration New $0.00
Subtotal: $35.00
Sales/Use Tax: $0.00
Credit Applied ($1.00)
Total: $34.00
Payment Method Amount Authorization Number Name
CASH $40.00
Total Due: $34.00
Amount Paid: $40.00
Change Due: $6.00
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Within 1&bt siness days, you will receive your permanent driver's license or identification card through the United States mail.
You will be able to track the progress of your credential review by visiting www.myBMV.com and logging into your personal
account. If you do not receive your credential within 10 business days or you have questions/comments, please call the BMV
Customer Service Center at 888-myBMV-411 (888-692-6841).
Please help us improve our service by completing as one-minute customer satisfaction survey. Your responses are completely
confidential. Visit http://www.in.gov/bmvsurvey/start and enter the survey code 188627204 to get started. Thank ou.
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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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T9984
COOPER, JEFFREY W. Purchase Order No.
WASTEWATER PLANT Terms
Due Date 10/29/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/29/201: COOPER, J $34.00
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
Date Officer
VOUCHER # 136699 WARRANT # ALLOWED
T9984 IN SUM OF $
COOPER, JEFFREY W.
WASTEWATER PLANT
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
COOPER,J 01-7042-05 $34.00
Voucher Total $34.00
Cost distribution ledger classification if
claim paid under vehicle highway fund