245606 05/20/15 CITY OF CARMEL, INDIANA VENDOR: 353874
b ONE CIVIC SQUARE ROGERS & CO OF INDIANA, INC CHECK AMOUNT: $*******166.60*
CARMEL, INDIANA 46032 6364 WESTFIELD BLVD CHECK NUMBER: 245606
9, _roN INDIANAPOLIS IN 46220 CHECK DATE: 05/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 10653 166.60 REPAIR PARTS
CO*-O E s C of Indiana,Inc. - CUSTOMER
6364 WESTFILED BLVD, INDIANAPOLIS,IN 46220 THIS SUP MUST ACCOMPANY INVOICE NO. 10653
PHONE:(317)255-3171 www.rogerspools.nneet ALL CLAIMS AND RETURNED GOODS
S G 14rin�L STi'eer ��P► , H NAME
O
L
D I ADDRESS
T T CITY STATE
O p
DATE `J SALESMAN ❑CASH ❑REC.ACCT. SHIP VITA % ❑Ppd TERMS CUSTOMER
/ (J ❑Coll. op-1
N� ORDER NO.
CHARGE ❑REfD.MDSE. �
DEPT. F.O.B. 3 f=OUAIT/9��-
/ 4 ❑C.O.D. ❑
QUANTITY DESCRIPTION PRICE ACCOUNT
2q7 `6( 6
SALES TAX
REC ED BY
TOTAL $ 4=v
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))
05/14/15 10653 $166.60
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
Rogers and Company of Indiana
IN SUM OF $
6364 Westfield Blvd.
Indianapolis, In 46220
$166.60
ON ACCOUNT OF APPROPRIATION FOR -
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#lrITLE I AMOUNT Board Members
2201 I 10653 I 42-370.001 $166.60 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
//Fridifiay, 15, 2015
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9s �g eR�r i�§ ?r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund