242915 3 /11/2015 J,i 4� . CITY OF CARMEL, INDIANA VENDOR: 357200
® ONE CIVIC SQUARE CANNON IV, INC CHECK AMOUNT: $*******180.00`
s =� CARMEL, INDIANA 46032 PO BOX 697 CHECK NUMBER: 242915
v�Irux�'� INDIANAPOLIS IN 46206-0697 CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4350000 INV415992 180.00 EQUIPMENT REPAIRS & M
Service Invoice
with Details
Invoice Number: INV415992
Date: 03/02/2015
950 Dorman treet Indianapolis,IN 46202-3544 Account Number: 5712414
P: 317-951-0500 F: 317-951-0600 PO Number:
Invoice Total: $180.00
2200 H150000
Bill To:
City Of Carmel
One Civic Square ':�W&k-06:16r-Da PavmentTiaHn'! 'P eni:�Due
03/02/2015 W0194377 Net 30 Days 04/01/2015
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PLEASE REMIT ALL PAYMENTS TO:
CANNON IV,INC.
�
P.O. BOX 097Anybic �
INDIANAPOLIS,[N46206-0697
18006
co kik.. 2015
CARMEL
F1 CITY ENGINEEF�
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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
Cannon IV, Inc. Purchase Order No.
P.O. Box 697 Terms
Indianapolis, IN 46206-0697 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
3/2/2015 INV415992 Service call for the HP plotter $ 180.00
Total $ 180.00
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.
Cannon IV, Inc. ALLOWED 20
P.O. Box 697 IN SUM OF$
i
Indianapolis, IN 46206-0697
$ 180.00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# I hereby certify that the attached invoice(s), or
0 INV415992 2200-4350000 $ 180.00 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
�j
i11
3/9/2015
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund
v