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HomeMy WebLinkAbout226881 12/10/2013 ».F CITY OF CARMEL, INDIANA VENDOR: 061152 Page 1 of 1 ONE CIVIC SQUARE CLAY TWP REGIONAL WASTE DISTRIClHECK AMOUNT: $1,658.16 `4 CARMEL, INDIANA 46032 PO BOX 40638 INDIANAPOLIS IN 46240-0638 CHECK NUMBER: 226881 CHECK DATE: 12/10/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4348500 454 . 25 0101016210101 1091 4348500 630 . 94 4000400010100 1120 4348500 59 . 62 0376122604988 1120 4348500 66 . 36 2000130154000 1125 4348500 27 . 56 0101006272502 1125 4348500 50 . 20 0143006091230 1125 4348500 76 . 75 0341578281126 1125 4348500 30 . 76 1015000014110 2201 4348500 261 . 72 2000240134001 F The r.issiot7 of the Ofstt'ct-tt?t'it 3 iu+ a hl"oh e!`IUL+Ve a t.t 11 a4 el 1 Clay Township Regional Waste District _ y, cTRwi3' P.O.Box 40638 Indianapolis,IN 46240-0638 Customer MONON CARMEL CLAY PARKS Service Address: 1430 96TH ST E Account Number 0143006091230 Billing Date 12/06/2013 07/13/1000'.303 00003003013120211.1 CGOCIAY EPO I OZ DOIA ILI CGO0000'159541 UT Customer Message CARMEL CLAY PARKS&REC MONON 1411 E. 116TH STREET c CARMEL IN 46032-7611 DEC ® 6 2013 Previous Balance $74.92 Period From: 11/06/2013 ! Payments -$74.92 Period To: 12/06/2013 3 Adjustments 50.00 - Total Past Due $0.00 Service Description Meter Number Cons. (1000 gallons) Amount Metered Comm Primary- 1 1/2 In Meter 60353811 3.00000 A 50.20 I ImwQrt�t KIN ft $50.20 a The Dlstnct staff�would Ilke to wish a�l�of our cu�stomersa Safe,and jkHollday Season Give the gtft of Ilfe by donating blood please Coln the s� Due Date 12/20/2013 Dlstnct staff on December 11 from 10 15 to 11 45 to donate,afithesClay �� Townsiip`Government Center This month s insert�`�How to Avoid the � �� -`_���, ������ -"� _. Sewer Scrooge Our office wdl be closed December 23 24 25 31 and ,� � - � ��� $50 20� , � a': �.,„.,.':_... �... N. ....':,-„ .. ....� . .- _._...• .. .:..ter_ ., ,. .,:o.. .L ,... Retain tns aert on icr your re coraS F Y,..s•euy, e{I°U4r 1111,14 Srt is ,'lo our Cr U ° xx Clay Township Regional Waste District CTRWD P.O.Box 40638 � � Indianapolis,IN 46240-0633 Customer CARMEL CLAY PARK & REC Service Address: 3100 116TH ST W Account Number 0341 578281 1 26 Billing Date 12/06/2013 071 2)10 00.30 3 0000296:0131 V 2 LL I CG0 CLAY EPD I o.DOM I L I CG00000.150541 UT III' '��'I'I��II'I'II. 'lll�l'II"�'�IIIIII'I'�I�II'I��I"�I�II� Customer Message CARMEL CLAY PARK&REC 1411 E. 116TH ST. CARMEL IN 46032-7611 T;-7 717,D Previous Balance $83.50 Period From: 11/06/2013 ; DEC 6 2013 Payments -$83.50 Period To: 12/06/2013 Adjustments $0.00 Total Past Due S0.00 Service Description Meter Number Cons. (1000 gallons) Amount Metered Comm Primary-2 In Meter 60268700 2.00000 A 76.75 Itt1QYttlt ittfoitian�m $76.75 The Distract staff woultl hke to wish all of our customersaSafe'and Happy" ,Holiday Season lve th gtft of Ilfe by donating blood please�o n the Due Date 12/20/2013 Dlstnct staff onyDecember 11 from 10 15 to 1.1 45 todonate at the Clay � Townshlp GovemmentCeriter�T�hls month s i sn ert How to Avmd the" .� � ��� �. ��' _ Sewer Scrooge0ur office well be closed December 23 24 25 31 and � ���,. January $76 75 Retain this Dortion f,--,r your rerordS F The Vission of the Disuict-iii i rovide a hijoh ouafih".Cost effective rl 11ClV sewer pal F our G' r u f Clay Township Regional Waste District 9 g CTRNID P.O,Box 40638 e ki m t k ` Indianapolis,IN 4640-0638 ��AFvlts«.+tn, Customer CARMEL CLAY PARK& REC Service Address: 1411 116TH ST E Account Number 1015000014110 Billing Date 12/06/2013 07/12110 09.30 3 0000201 20131202 U CGU CLAY EPD 1 ox DOM IL 1 CG00000'150511 UT IIIII�IIIII��III���I����IIII�II�IIIIIIII�I���I��'I'III�"IIII'�II Customer Message CARMEL CLAY PARK&REC 1411 E. 116TH ST. CARMEL IN 46032-7611 e [1t� L�13 Previous Balance $10.54 Period From: 11/06/2013 Payments -$10.54 Period To: 12/06/2013 t -=----___- � Adjustments $0.00 Total Past Due S0.00 Service Description Meter Number Cons. 11000aallonsl Amount Metered Comm Primary-5/8 In Meter 35379081 9.00000 A 30.76 �R Zv., P;. t#4ii iJ3 taldt IWBIIAQt18AEi 'h ` �.� "\.w $30.76 Wi TheMistnct staff would like to wish all of our customers a Safeand Happy � . Holiday Season Give thegift of life6y donating blood;please join the ` Due Date 12/20/2013 Distnctstaff on December 11 from0 15 to145 to�do�nate atUie Clay ; Town shiGove rnment Center This month s insert How to Avoid the a SewerScrooge0ur office wdl beclosed December 23 24 25-2 1 ands a � $30.76 January 1 r �, � ,o .�,.u•, �< ��. •la`s �� •,P�.._,.,_.Q'I,. r�_ Reta n this portion?or your records - — - _ -- ----- r ThP vUsslon of the Distr C?-to provide a;'gh..uah y;co.,. - � - rffP7}!L8 saaitalv 561hE1tiei �J � t � rr 4 Clay Township Regional Waste District Mr »` thil 81 CTRWID PO.Box 40638r Indianapolis,IN 46240-0638 .__ Customer CARMEL CLAY PARKS Service Address: 1235 CENTRAL PARK DR E Account Number 0101006272502 Billing Date 12/06/2013 07/12110 0 M 3 0000208 20131202 IL 1CGO Cl Y EPO 1 a DOM ILI CC WOO'159561 UT �II'�I�I'I���I'llll�llllll'I.II.���I��IIII�'lll'll�llllll��l""' Customer Message CARMEL CLAY PARKS 1411 E 116TH ST :¢ CARMEL IN 46032-7611 LIBY v 6 211 3 I Previous Balance $27.56 Period From: 11/06/2013 Payments -527:56 Period To: 12/06/2013 _ _ Adjustments $0.00 Total Past Due S0.00 Service Description Meter Number Cons. (1000 gallons) Amount Metere Comm Primaryy Fog- 1 In Meter 0101006272 0.00000 E 27.56 trn octant In#ortrtatlothx $27.56 The Distract staff woulii Ilke to mnshgall of oui c�ustomersSa fe'antl;Ha PPy3 Holiday SeasonGlve thgift of Iife#by donat�ingblood pleasefo the Due[}ate 12/20/2013 �Dlstnct staff on December 11�from 10 15 to11 45 to donate atthe Clay- Townshlp,Govemment Center his month s insert How to Avoid the $ ' Sewer�Scrooge Ou`r office will be closed December 2324 25 31 and s° $27.56 Januarya1 �� � m Retain to s Dorton for your rrord F The NIUss,"on of the D'sUict-to provide a hiah(`ivaQt'Y,L:,: Pffpe 7VE sa3!tal y 5e!bE J tiRi vice to our r i 7 ur +, u Clay Township Regional Waste District t ,h a CTRWD P.O.Box 40638t } fit Indianapolis,IN 46240-0638 qeP Customer CARMEL CLAY PARKS Service Address: 1235 CENTRAL PARK DR E Account Number 0101016210101 Billing Date 12/06/2013 07/11iOW.303 OM250201312021L 1 CG9C YEM 1o:DOM IUCG90000'150541 UT 1I1�I�IIIII'I�III'1II1'I Jill Jill 1111111I'Jill 11'1"1111111 Customer Message CARMEL CLAY PARKS 1411 E 116TH ST c CARMEL IN 46032-7611 �7 y¢P Previous Balance $72.26 6 2013 Period From: 11/06/2013 Payments -$72.26 Period To: 12/06/2013 V — _.� Adjustments $0.00 Total Past Due $0.00 Service Description Meter Number, Cons. 1000 gallons) Amount Metered Comm Primary Fog-2 In Meter DEC ® r 9,73458 170.00000 A 454.25 ,� _ � _ Imp s tart IrlftarafilQriMP11,11 KEEP $454.25 s � > The Distract staff woultl Itke to wish all o 6urcustomers a Safe and Happyx , —-- Holiday Season Glve the giftFof hfeby donating blo d lease loin the Due Date 12/20/2013 Distnct<staff on De ember 11'froM 15 to 1f1 45 to donate at the Clay �"*T:ownshipp�Government C�e�nter Th s�mont s insert F Now to�AVo�d the �� > � ®�• Sewer Scrooge0ur officewdl be closed December 23 2425 X31 and ti F � �� �� � z Ya m • w:1 �°��,�, $454.25 Retain the portion foryour recoruS F The Mission of the Cfst'ict-to provide«i-401l ojaai ty! erfec fVe samtary se"I'vef se e P Ur r u Clay Township Regional Waste District n�x•CTRWO P.O.Box 40638 M R Indianapolis,IN 46240-0638 � � < C" �44..xF1'�St6 Customer CARMEL CLAY CENTRAL Service Address: 1235 CENTRAL PARK DR E Account Number 4000400010100 Billing Date 12/06/2013 01/1211000'.303 0000205 2013 M2 I I CGO CLAY EM I of DOM IUCG00000'150561 UT 1I'1111'I" I1IIII'111111111111 111111111111'1'1I Customer Message CARMEL CLAY CENTRAL PARK 1411 E 116TH ST CARMEL IN 46032-7611 Im �-7 7K, T °1 ! Previous Balance 6725.31 Period From: 11/06/2013 Payments -$725.31 Period To: 12/06/2013 DEC- ® � 213 Adjustments 60.00 i Total Past Due $0.00 Service Description Meter Number Cons. (l000cianons) Amount Metered Comm Primary Fog-2 In Meter -59392985 0.00000 A 630.94 59392986 106.00000 608631.33 0.00000 � I €trtantIril4rrnatla � �y s e WK. $630.94 p The Distnct staff would hkto wish II of our customers a Safe and�Happy -- HohdaySeasonGive th got hfe by donafing blood;please join the E. D�stnct staffon Deember 11 from 10 54to 11 45 to donate t the Clay tae Gate 12/20/2013 TownshipGovernment Center This month s insert How to Avoid�the , & ty Sewer Scrooge Our office will be closed December 23 24 25 31 and $6 January 1 Retain this portion for your records ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 061152 Clay Twp Regional Waste District Terms PO Box 40638 Date Due Indianapolis, IN 46240-0638 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/6/13 143006091230 1430 E 96th St- South Trailhead 6-Nov. $ 50.20 12/6/13 341578281126 3100 W 116th St- West Park $ 76.75 12/6/13 1015000014110' 1411 E. 116th St. -Adm. $ - 30.76_ 12/6/13 101006272502 1235 Central Park E. Dr. - Monon Center $ 27.56 12/6/13 101016210101 1235 Central Park E. Dr. - Monon Center $ 454.25 12/6/13 4000400010100 1235 Central Park E. Dr. - 6 meters $ 630.94 Total $ 1,270.46 with IC 5-11-10-1.6 , 20 Clerk-Treasurer i Voucher No. Warrant No. 061152 Clay Twp Regional Waste District Allowed 20 PO Box 40638 Indianapolis, IN 46240-0638 In Sum of$ $ 1,270.46 ON ACCOUNT OF APPROPRIATION FOR 101 General & 109 Monon Center PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members Dept# 1125 143006091230 4348500 $ 50.20 1 hereby certify that the attached invoice(s), or 1125 341578281126 4348500 $ 76.75 bill(s) is(are)true and correct and that the 1125 1015000014110 4348500 $ 30.76 materials or services itemized thereon for 1091 101006272502 4348500 $ 27.56 which charge is made were ordered and 1091 101016210101 4348500 $ 454.25 received except 1091 40004000101oo 4348500 $ 630.94 6-Dec 2013 Signature $ 1,270.46 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund The Mission of the District-to provide a high quality,cost- p p•Nq effective sanitary sewer service to our community. •CTRWD•� Clay Township Regional Waste District �©����� ��������� P.O.Box 40638 Indianapolis,IN 46240-0638 �a p5 AL'GIONP�W Customer FIRE STATION #46 Service Address: 540 136TH ST W Account Number 2000130154000 Billing Date 12/06/2013 0]11211009.303 WOW 33201312021LICG I U I CLAYSTMT I.,DOM IL 1CG100-159511 UT Customer Message FIRE STATION#46 2 CIVIC SQUARE i��•*JM CARMEL IN 46032-2584 .4,tiF Previous Balance $66.36 Period From: -i 1706i20•i3 Payments -$66.36 Period To: 12/06/2013 Adjustments $0.00 Total Past Due $0.00 Service Descrintion Meter Number Cons. (1000 gallons) Amount Metere Comm Primaryy Fog - 1 In Meter 48889163 5.00000 A 66.36 48889164 6.00000 Important Informations D $66.36 The District staff would like to wish all of our customers a Safe and Happy Holiday Season.Give the gift of life by donating blood; please join the Due Date D 12/20/2013 District staff on December 11 from 10:15 to 11:45 to donate at the Clay Township Government Center.This month's insert-How to Avoid the Sewer Scrooge.Our office will be closed December 23,24,25, 31 and $66.36 January 1. 02-1 x09-2750(12/09) Retain this portion for your records a�e��'a .Hq�kTOy� REMIT TO: CLAY TOWNSHIP REGIONAL WASTE DISTRICT P.O. BOX 40638 4 CTRWD• �< INDIANAPOLIS, IN 46240-0638 (317) 844-9200 r v v �4 5 gy Hm RECioNa�v+PS��Q. Visit our website: www.cctrwd.org PAYMENTS: Please be sure to include the bottom portion of this statement with your check or money order. Do not send cash by mail. Stapling or folding the payment stub may substantially delay the processing of your payment. You may pay your sewer bill in person at our office at 10701 N. College Ave.Suite A, Indianapolis, IN. For your convenience, you may also use our drive-up drop box at this address. Customer Service: If you have additional questions concerning your bill, please visit our office at 10701 N. College Ave. Suite A, Indianapolis, IN or call (317) 844-9200 Monday through Friday, 8:00 a.m. to 4:30 p.m. NON-PENALTY PERIOD AND LATE PAYMENT CHARGES: Current charges become delinquent if not paid by the 20th of the month. If any portion of the current charges remain unpaid after the 20th of the month, a 10 percent late fee charge will be added to your account. AUTODEBIT is available for making your monthly payment. The form can be downloaded from our website. Additional Information: A-Actual meter readings E-When printed after a meter reading (previous or current) indicates an estimated reading CR - Credit amount B - Balanced billing applies to our residential customers only. Your monthly statements will be based on your winter consumption or if you do not yet have winter consumption history, billing will be based on an average residential monthly usage of 7,000 gallons per month. Approved by State Board of Accounts for Clay Township Regional Sewer District, 2009 02-1x09-2 750(12/09) The Mission of the District-to provide a high quality,cost- 'Hp.„4 effective sanitary sewer service to our community. Clay Township Regional Waste District •CTRWD• P.0.13ox40638 ManNy Statement Indianapolis,IN 46240-0638 tea¢ AEGIMNLW� Customer FIRE STATION #42 Service Address: 3610 106TH ST W Account Number 0376122604988 Billing Date 12/06/2013 07/12/1009303 0006132201312021LICG101 CLAVSTMT toe DOM IL1CG10000'159S11 UT I.I�II��III'I'I�I'IIIIII���II��I��IIIIIII'llll�"'ll��'�����'� Customer Message FIRE STATION#42 2 CIVIC SQUARE CARMEL IN 46032-2584 Previous Balance $64.11 Payments 4641-1-- Period To: 12/06/2013 Adjustments $0.00 Total Past Due $0.00 Service Description Meter Number Cons. (1000 gallons) Amount Metered Comm Mich Rd Fog - 1 In Meter 10856168 4.00000 A 59.62 10856207 4.00000 Important Information ftm D $59.62 The District staff would like to wish all of our customers a Safe and Happy Holiday Season.Give the gift of life by donating blood; please join the Due Date D 12/20/2013 District staff on December 11 from 10:15 to 11:45 to donate at the Clay Township Government Center.This month's insert-How to Avoid the Sewer Scrooge.Our office will be closed December 23, 24, 25, 31 and $59.62 January 1. a]2?&P� D Retain this portion for your records 02-1X09-2750(12/09) REMIT TO: CLAY TOWNSHIP REGIONAL WASTE DISTRICT P.O. BOX 40638 CTRWD• INDIANAPOLIS, IN 46240-0638 (317) 844-9200 r v 4` Visit our website: www.ctrwd.org REGIONPL��'S PAYMENTS: Please be sure to include the bottom portion of this statement with your check or money order. Do not send cash by mail. Stapling or folding the payment stub may substantially delay the processing of your payment. You may pay your sewer bill in person at our office at 10701 N. College Ave.Suite A, Indianapolis, IN. For your convenience, you may also use our drive-up drop box at this address. Customer Service: If you have additional questions concerning your bill, please visit our office at 10701 N. College Ave. Suite A, Indianapolis; IN or call (317) 844-9200 Monday through Friday, 8:00 a.m. to 4:30 p.m. NON-PENALTY PERIOD AND LATE PAYMENT CHARGES: Current charges become delinquent if not paid by the 20th of the month. If any portion of the current charges remain unpaid after the 20th of the month, a 10 percent late fee charge will be added to your account. AUTODEBIT is available for making your monthly payment. The form can be downloaded from our website. Additional Information: A-Actual meter readings E-When printed after a meter reading (previous or current) indicates an estimated reading CR - Credit amount B - Balanced billing applies to our residential customers only. Your monthly statements will be based on your winter consumption or if you do not yet have winter consumption history, billing will be based on an average residential monthly usage of 7,000 gallons per month. Approved by State Board of Accounts for Clay Township Regional Sewer District, 2009 02-1x09-2750(12/09) VOUCHER NO. WARRANT NO. ALLOWED - 20 Clay Twp. RWD IN SUM OF $ P.O. Box 40638 Indianapolis, IN 46240 $125.98 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 2000130154000 43-485.00 $66.36 1 hereby certify that the attached invoice(s), or 1120 0376122604988 43-485.00 $59.62 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 DEC - 9 2013 a, 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)) 2000130154000 $66.36 0376122604988 $59.62 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 The Mission of the District-to provide a high quality,cost- 'N' effective sanitary sewer service to our community. W� Clay Township Regional Waste District n CTRWD• P.O.Box 40638 m nj Ny Matement e Indianapolis,IN 46240-0638 g8yawt'MP' Customer CARMEL ST DEPT Service Address: 3400 131 ST ST W Account Number 2000240134001 Billing Date 12/06/2013 0)11211009]030 7560201342021 L I CG102 CLAYSTMT IOZ DOM ILI CG I()­0'15981 I UT III'). ' III'�II�II�I�I�"'IIIII��'I"II��'�"I�I'lllll"I'I���1� Customer Message CARMEL ST DEPT 3400 W 131 ST ST CARMEL IN 46074-8267 Previous Balance $263.97 Period-From: 11/06/2013 Payments -$263.97 Period To: 12/06/2013 Adjustments $0.00 Total Past Due $0.00 Service Description Meter Number Cons. (1000 gallons) Amount Metered Comm Primary-2 In Meter 60121546 5.00000 A 261.72 60334360 12.00000 60360195 3.00000 Important Information ffmm�M&W(W D $261.72 The District staff would like to wish all of our customers a Safe and Happy Holiday Season.Give the gift of life by donating blood; please join the Due Date D 12/20/2013 District staff on December 11 from 10:15 to 11:45 to donate at the Clay Township Government Center.This month's insert-How to Avoid the D Sewer Scrooge.Our office will be closed December 23,24,25, 31 and January 1. Cn $261.72 GAPE°o 02-1 x09-2750(12/09) Retain this portion for your records o� �n •HA�ur�o REMIT TO: CLAY TOWNSHIP REGIONAL WASTE DISTRICT P.O. BOX 40638 �` gy •CTRWD• INDIANAPOLIS IN 46240-0638 y (317) 844-9200 Y U � ti¢ 5 gEG10NP��PS��� Visit our website: www.ctrwd.org PAYMENTS: Please be sure to include the bottom portion of this statement with your check or money order. Do not send cash by mail. Stapling or folding the payment stub may substantially delay the processing of your payment. You may pay your sewer bill in person at our office at 10701 N.College Ave. Suite A, Indianapolis,IN. For your convenience, you may also use our drive-up drop box at this address. Customer Service: If you have additional questions concerning your bill, please visit our office at 10701 N. College Ave. Suite A, Indianapolis, IN or call (317) 844-9200 Monday through Friday, 8:00 a.m. to 4:30 p.m. NON-PENALTY PERIOD AND LATE PAYMENT CHARGES: Current charges become delinquent if not paid by the 20th of the month. If any portion of the current charges remain unpaid after the 20th of the month, a 10 percent late fee charge will be added to your account. AUTODEBIT is available for making your monthly payment. The form can be downloaded from our website. Additional Information: A-Actual meter readings E-When printed after a meter reading (previous or current) indicates an estimated reading CR -Credit amount B - Balanced billing applies to our residential customers only. Your monthly statements will be based on your winter consumption or if you do not yet have winter consumption history, billing will be based on an average residential monthly usage of 7,000 gallons per month. Approved by State Board of Accounts for Clay Township Regional Sewer District, 2009 oz-,x09-2750(12/09) VOUCHER NO. WARRANT NO. ALLOWED 20 Clay Township Regional Waste District IN SUM OF $ P. O. Box 40638 Indianapolis, IN 46240-0638 $261.72 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I ( 43-485.001 $261.72 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 Mond�/De inl5y UZ'013 �y i WNW Eetii'RiOner 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)) 12/06/13 $261.72 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