246693 06/30/15 9, �,_c,A" CITY OF CARMEL, INDIANA VENDOR: 359344
ONE CIVIC SQUARE AYERS BACKFLOW CHECK SERVICE CHECK AMOUNT: $'"'""`250.00'
CARMEL�'a CARMEL, INDIANA 46032 20 BENNETT ROAD CHECK NUMBER: 246693
9M�roi"�°' CARMEL IN 46032 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350100 376800 250.00 BUILDING REPAIRS & MA
36000
SOLD TOSHIPPED TO
C �L G Ayers Backflo# Check Sera
ADDRESS �-� ADDRESS 20 Bennett Ind.
CITY,STATE,ZIP CITY,STATE,ZIP ' 1 `'
c- ��'� y�D 3 z-- 575-0782
CUSTOM ER ORDERNO. SOLD 6Y TERMS F.0 H. bATP
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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.
359344 Ayers Backflow Check Ser Terms
20 Bennett Rd
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
6/2/15 376800 Backflow preventer servicing xa2298 $ 250.00
Total $ 250.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20_
Clerk-Treasurer
4
Voucher No. Warrant No.
359344 Ayers Backflow Check Ser j Allowed 20
20 Bennett Rd
Carmel, IN 46032
In Sum of$
$ 250.00 i
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund j
r
i
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1125 376800 4350100 $ 250.00 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
June 25, 2015
Signature
$ 250.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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