248430 08/12/15 44iC"q«f CITY OF CARMEL, INDIANA VENDOR: 359067
® it ONE CIVIC SQUARE LINE X OF INDY CHECK AMOUNT: S"""""""200.00"
:. � CARMEL, INDIANA 46032 1601 COUNTRY CLUB ROAD CHECK NUMBER: 248430
INDIANAPOLIS IN 46234 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 4374 200.00 REPAIR PARTS
LINEX Line-X of Indy Invoice
8448 Moller Rd
nfindy Indianapolis, IN 46268 Date Invoice#
(317)228-0123 08/05/2015 4374
gelinexofindy@hotmail.com Terms Due Date
http://www.linex-indy.com
Due on receipt 08/05/2015
Bill To
Carmel Street Dept.
3400 W. 131 st Street
Westfield,IN 46074
United States
Amount Due Enclosed
$200.00
Please detach top portion and return with your payment
Date Description Quantity Rate Amount
08/05/2015 LineX Coating-Street Sweeper Tube 1 100.00 100.00
per James Bentley
Sanding and LineX
08/05/2015 LineX Primer 1 25.00 25.00
08/05/2015 Labor for Installation or Repair Sandblasting 1 75.00 75.00
Total $200.00
Thank you for your business!
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))
08/05/15 4374 $200.00
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
Line-X of Indy
IN SUM OF $
8448 Moller Rd.
Indianapolis, IN 46268
$200.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 4374 I 42-370.001 $200.00 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
Thur day, gu t�QO, 015 17/ Lr A111
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s
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Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund