227552 12/19/2013 CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE C�
CARMEL, INDIANA 46032 �(� ,�t-V CHECK AMOUNT:
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CHECK NUMBER: 227552
CHECK DATE:
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION ! /
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.3S2
RECEIPT
HAMILTON COUNTY AUDITOR 4 . 76
I h i✓ �•� FUND
NOBLESVILLE, IN, 12- 20
RECEIVED FROM �i ��� (�U , $ Ab
THE SUM OF (Y I S� DOLLARS
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ON ACCOUNT OF
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PAID BY: ❑CASH C/�HE�CKy ❑M.O. A U T H SIGNATURE
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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.
nPayee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or no 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 accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
1 ALLOWED 20
1 V lY
1 K Q lion r-1 1: W
ON ACCOUNT OF APPROPRIATION FOR
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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
A, a 110&"M 4
ignature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund