240795 01/07/15 c` CITY OF CARMEL, INDIANA VENDOR: 368101
® I ONE CIVIC SQUARE RAMA CAR WASH CHECK AMOUNT: $*******250.00*
�., CARMEL, INDIANA 46032 431 EAST CARMEL DRIVE CHECK NUMBER: 240795
'M,�roN.Eo. CARMEL IN 46032 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4351100 32255 250.00 CAR WASH BOOKS
INVOICE
December 16, 2014
City of Carmel Police Department
3 Civic Square
Carmel, IN 46032
Rama Car Wash Books
10 Books $25.00
TOTAL AMOUNT DUE: $250.00
Please make check payable to:
Rama Car Wash
431 E. Carmel Dr.
Carmel, IN 46032
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ONINVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
i2n5=14
Rm2 CarVksh C2Mol Pollco Dopzftmom
VENDOR SHIP 3 CIVIC squaw
M E. C@mol Dfive TO C@mal, IN 4
COMM, IN 4= 571
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
I
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.699.00
10 Each Book car washes $23.00 $230.00
Sub Total: $230.00
..
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� 61 •0 ° l
0 H Send Invoice To: �~� �"�--
Camol Pollco Dopartmont
Alan: Pzt Young
3 Citric Squ@m
Cuffi®l, IN a=- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECTACCOUNT AMOUNT
Camel Police Dept. PAYMENT Mao
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION�SW��NT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. ///�
I
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �'
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ���clilco
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 32255 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. —WARRANT
ALLOWED 20
_ IN THE SUM OF$
r,.
ON ACCOUNT OF APPROPRIATION FOR
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
-_-- -----_---Signature
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))
01/02/15 car wash tickets $250.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Rama Car Wash
IN SUM OF $
431 E. Carmel Drive
Carmel, IN 46032
$250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32255
Encumbered 43-511.00 $250.00 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
Wednesday, Dece ber 31, 2014
/ z
�/Z
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund