246357 06/17/15 ��p" CITY OF CARMEL, INDIANA VENDOR: 354857
} ONE CIVIC SQUARE HOOSIER PORTABLE RESTROOMS INC CHECK AMOUNT: $*******130.00*
f� ?� CARMEL, INDIANA 46032 2201 E 99TH ST CHECK NUMBER: 246357
, INDIANAPOLIS IN 46280 CHECK DATE: 06/17/15
� ��ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4353099 10647 130.00 OTHER RENTAL & LEASES
>,-�'cr,r Invoice
License #zg-o3i/33/35 I
HOOSIER zzoi E MAY 2 8 2015 ggth Street Date Invoice #
IndianapoCis,IX46z8o L-- 5/15/2015 10647
Bill To: Customer Phone
Carmel Clay Parks Department 573-4026
Attn: Dawn Koepper
1411E 116th 5t
Carmel, IN 46032 Customer Alt. Phone
P.O-. No. Terms Project - --
#XX-2168 Due upon receipt, please. Restrooms out
Item Service Dates } ,:Quantity Rate AmOU111.,,
5tandard Unit(s) Serviced - 5E 05/15/2015 2 65.00 130.00
Total $130.00
Office : (317) 844-6919
Email: hoosierportables@gmadcom o ,rFa
-Website: www.hoosierportabCes.com -
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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:
354857 Hoosier Portable Restrooms, Inc. Terms
2201 E. 99th Street
Indianapolis, iN 46280
Invoice Invoice: Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
5/15/15 10647 Portalet rental West Park 5/15- 5/18/15 xa2168 $ 130.00
Total $ 130.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with I C 5-11-10-1.6
, 20_
Clerk-Treasurer
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Voucher No. Warrant No.
354857 Hoosier Portable Restrooms, Inc. Allowed 20
2201 E. 99th Street
Indianapolis, iN 46280
In Sum of$
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$ 130.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
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PO#or INVOICE NO. CCT#rr]TL AMOUNT I Board Members
Dept#
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1125 10647 4353099 $ 130.00 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
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June 11, 2015
Signature
$ 130.00 Accounts Payable Coordinator
Cost distribution ledger classification if I Title
claim paid motor vehicle highway fund
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