230576 03/26/14 r Ley'.
�. ...,_,wF CITY OF CARMEL, INDIANA VENDOR: 00350781
;_ ® ONE CIVIC SQUARE PICKETT'S PLACE CHECK AMOUNT: $*******120.00*
r CARMEL, INDIANA 46032 547 E 161 ST ST CHECK NUMBER: 230576
9M1FoN.c�` WESTFIELD IN 46074 CHECK DATE: 03/26/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 1775 120.00 REPAIR PARTS
P®ckett's Place U V 0 C
547East '61st Street Invoice Number:
WestFe/d, /N 46074 1775
Voice: (317) 896 3271 Invoice Date:
Sold To: Fax: (317)896 2036 Mar 13, 2014
Page
1
Carmel Street Department
3400 West 131st Street
WestDe/d, /N 46074
USA
Customer ID Customer PO Shipping Method Payment Terms Due Date
VERBAL, MIKE Cust. Pickup Net 30 Days 4/12/14
Quantity Item Description Unit Price Amount
6.00 FACE FLANGE SURFACE ON WATER 20.00 120.00
COUPLERS
Subtotal 120.00
Sales Tax
Total Invoice Amount 120.00
Check/Credit Memo No:
Payment/Credit Applied
TOTAL 120.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pickett's Place
IN SUM OF $
547 E. 161st St.
Westfield, IN 46074
$120.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 1775 I 42-370.001 $120.00 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
A
Thur , March 20, 2014
Street C0441sioner
Street Cori 111 1ISS101-101-
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))
03/13/14 1775 $120.00
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
20
Clerk-Treasurer