244423 4 /21/2015 CITY OF CARMEL, INDIANA VENDOR: 367107
ONE CIVIC SQUARE ALGALCO LLC CHECK AMOUNT: $*****5,000.00*
=Q CARMEL, INDIANA 46032 PO BOX 502768 CHECK NUMBER: 244423
9Jq�tON..�pINDIANAPOLIS IN 46250 CHECK DATE:' 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 121 117.72 OTHER CONT SERVICES
2201 R4350900 31885 121 4,882.28 HYDROGEN FUEL SYSTEM
Al•G�J��� _
AIGaICo LLC DATE: January 20, 2015
Hydrogen on Tap TM INVOICE## 121
FOR: Hydrogen Fuel System PO#31885
P.O. Box 502768
Indianapolis,.IN 46250 BILL TO: Attn: Dave Huffman
Phone:317.775.1094 Carmel Street Department
Fax:317.423.8211 3400 W 131 st Street
Westfield, IN 46074
Phone:317.733.2001
-- -- DESCRIPTION —_ —_ „_. IAMOUNT --
Hydrogen Fuel System $ -5,00-01-.00
SUBTOTAL $ 5,0.0. 0_.00
Terms:Net 30-days.
Make all checks payable to AIGalCo TAX RATE 0.00%
If you have any questions concerning this invoice,contact:
Kim Morris SALES TAX -
AIGalCo Business Development
kmorrs@algalcoonline.com-or-317.340.0211. OTHER -
THANK YOU FOR YOUR BUSINESS! TOTAL $ 5,000.00
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
AIGalCo, LLC
IN SUM OF$
P.O. Box 502768
Indianapolis, IN 46250
j
$5,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#lriTLE AMOUNT Board Members
2201 121 43-509.00 $117.72 1 hereby certify that the attached invoice(s), or
31885 121 43-509.00 $4,882.28 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
)Y4 Fri &, �!i 015
Title
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))
01/20/15 121 $117.72
01/20/15 121 $4,882.28
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