245969 06/03/15 y �,q+, CITY OF CARMEL, INDIANA VENDOR: 353874
J a `�
ONE CIVIC SQUARE ROGERS &CO OF INDIANA, INC CHECK AMOUNT: $********83.30*
,' S=� CARMEL, INDIANA 46032 6364 WESTFIELD BLVD CHECK NUMBER: 245969
��TON�;� INDIANAPOLIS IN 46220 CHECK DATE: 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4236400 10729 83.30 PAINT
R®GE R S & ®®of Indiana,Inc. CUSTOMER _ 10729®729
6364 WESTFILED BLVD. INDIANAPOLIS,IN 46220 THIS SLIP MUST ACCOMPANY INVOICE NO.
PHONE:(317)255-3171 www.rogerspools.net ALL CLAIMS AND RETURNED GOODS
�
r�vYv�^�. �.�t � i NAME
D -3 4o o l�-e� i 3( � P
ADDRESS
TT CITY STATE
O IiU-L s 7---�-� � .�� , Ct7 V `� O
DATE SALESMAN ❑CASH ❑REC.ACCL S I V A ❑Ppd TERMS CUSTOMER
kCHARGE
ORDER NO.
❑REfD.MDSE. ❑Coll.
AM
-DEPT. F.O.B. _ -�� -- -
I ---- ❑-C.O.D. El-
QUANTITY
QUANTITY DESCRI N / PRICE ACCOUNT
30
SALES TAX
RECEN By,,)' TOTAL $ ��
:.� .1.•�:.;.:.. .: ..
VOUCHER NO.' WARRANT NO.
ALLOWED 20
Rogers and Company of Indiana
IN SUM OF$
6364 Westfield Blvd.
Indianapolis, In 46220
- $83.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#IrITLE I AMOUNT Board Members
2201 10729 42-364.00 j $83.30 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
i
materials or services itemized thereon for
which charge is made were ordered and
received except
6
/iiur a 8 2015
�tt ��gl�l,a�ter
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))
05/19/15 10729 $83.30
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