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243891 04/08/15 (9, CITY OF CARMEL, INDIANA VENDOR: 369028 ONE CIVIC SQUARE AQUA FALLS BOTTLED WATER CHECK AMOUNT: S`"•"`•'20.00• CARMEL, INDIANA 46032 EPo NON X 98 46323 CHECK NUMBER: 243891 CHECK DATE: 04/08/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4353099 167594 20.00 OTHER RENTAL & LEASES INVOICE AQUA FALLS BOTTLED WATER Date: 03/31/2015 Invoice#167594 P.O. Box 98 Enon OH 45323 Direct all inquiries regarding this invoice to our accounting department at 937-864-5495 Bill To Ship To City Of Carmel Dept Comm Servi City Of Carmel Dept Comm Servi 1 Civic Square 1 Civic Square Carmel IN 46032 Carmel, IN 46032 /46032014/ Acct# 055041 Description Quantity Unit Price Taxable Monthly Mar- M0068056 1 @ 10.00 10.00 Monthly Mar- M0068256 1 @ 10.00 10.00 Invoice Total : 0.00 Previous Balance: Acct Balance ---- ----------------------------------------------------- Return Return This Portion With Payment City Of Carmel Dept Comm Servi Payment Voucher 1 Civic Square Carmel IN 46032 Account# Invoice# Invoice Date 055041 167594 03/31/2015 Due Date Upon Receipt Invoice Total Amount Paid AQUA FALLS BOTTLED WATER 20.00 P.O. Box 98 Enon OH 45323 /453230098989/ VOUCHER NO. WARRANT NO. ALLOWED 20 Aqua Falls Bottled Water ; IN SUM OF $ P.O. Box 98 Enon, OH 45323 $20.00 ON ACCOUNT OF APPROPRIATION FOR ,Carmel DOCS PO#/DeP t. INVOICE NO. ACCT#/T ITLE AMOUNT Board Members 1192 167594 43-530.99 $20.00 I hereby certify that the attached invoice(s), or I I I ; bill(s) is (are) true and correct and that the materials or services itemized thereon for i which charge is made were ordered and I received except Friday, April 03, 2015 I I ct Title I i Cost distribution ledger classification if claim paid motor vehicle highway fund i 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)) 03/31/15 167594 Coffee pot rental $20.00 r i I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with 1C 5-11-10-1.6 , 20 Clerk-Treasurer