DEKALB COUNTY GOVERNMENT —- ACCOUNTS PAYABLE

Date to bo 1'oicl OS/15/2012|J0a Department

till Fund

Vendor * S00

Claim#: 08/15/2012 - 1290 - 500

Invoice # Department

St Attv 5055

FIRST NATIONAL BANK OMAHA

P.O. BOX 2818

OMAHA NE 68103-2818

Line Item

Account

Vendor Total

Amount

$1,437.04 1

Memo on Check

o. -

Chock U

Fiscal Yo.u

Enclosures?

2012

NO

Certification initials:

r\mi NON-DEPARTMENTAL SERVICES: Believing everything to be correct, Iapprove this claim as ajust and necessary expense for myS*JX-\/^_ department and verify that the same has not previously been paid.

FINANCE OFFICE: The Deputy County Administrator hereby certifies that this claim hasbeen audited and conforms with the laws andregulations which pertain to the department submitting thisclaim.

Friday, August 03, 2012