238913 11/05/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 255850
ONE CIVIC SQUARE QUALITY REPAIR SERVICE, INC CHECKAMOUNT: $*******485.65*
CARMEL, INDIANA 46032 411 KNIGHT DRIVE CHECK NUMBER: 238913
GREENWOOD IN 46142 CHECK DATE: 11/05/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 21770 485.65 OTHER EXPENSES
Quality Repair Service, Inc. Invoice
411 Knight Drive Date Invoice#
Greenwood,IN 46142 10/10/2014 21770
Phone# 317-881-0205
Fax# 317-881-0294
Bill To
CITY OF CARMEL
760 3rd AVE. S.W.# 110
CARMEL,IN 46032
P.O. No. Terms Due Date Rep Project
514313 Net 30 11/9/2014 TAS 21770
Description Amount
ONE(1)KUBE SEAL KIT#96494664 479.00
FREIGHT 6.65
Subtotal $485.65
1.5 %FEE PER MONTH ON UNPAID INVOICES
Sales Tax (7.0%)
Total $485.65
Balance Due
Web Site -- -- ------- .� _��— ----- -
www.qualityrepairserviceine.com
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VOUCHER # 145843 WARRANT # ALLOWED
255850 IN SUM OF $
QUALITY REPAIR SERVICE
411 Knight Drive
GREENWOOD, IN 46142
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR f
Board members
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PO# INV# ACCT# AMOUNT j� Audit Trail Code
21770 01-7202-06 $485.65
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Voucher Total $485.65
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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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
255850
QUALITY REPAIR SERVICE Purchase Order No.
411 Knight Drive Terms
GREENWOOD, IN 46142 Due Date 10/29/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/29/201, 21770 $485.65
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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