248761 08/26/15 ** CITY OF CARMEL, INDIANA VENDOR: 00351240
ONE CIVIC SQUARE CHEM DRY BY KEVIN JONES CHECK AMOUNT: $*****7,647.44*
CARMEL, INDIANA 46032 1601 COUNTRY CLUB ROAD CHECK NUMBER: 248761
vMiioN La, INDIANAPOLIS IN 46234 CHECK DATE: 08126115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 33020 65885 7,647.44 WATER DAMAGE REPAIR
Chem-Dry by Kevin Jones
1601 Country Club Rd. Invoice
Indianapolis, IN 46234 Order No. Date
65885 7/27/2015
hem,D—ry® (317)273-9814 Start End
Dritt.Qmntt.Heallhitt.• WWW.chemdrybykevinjones.com 11:00 AM 12:00 PM
Customer Info. Service Location Job Info.
Name: Jellison,Ryan 9609 Hazel Dell Pkwy Technician:
Y y Kevin Jones
Phone:(317)571-2548 sales Rep: Jones,Kevin
Alt 1. Indianapolis,IN 46280 Lead Source: RepBuisness card 2015
Alt 2: Cross street: Last Sere: 7/27/2015
QTY Description Price Amount
1 W:Emergency Water Damages 4,297.44 4,297.44
1 W:Emergency Water Damages-D&D painting 3,350.00 3,350.00
Notes:D&D painting 2200 repairs and paint damage walls 1150 to paint other 3 walls in office and big
room. OK by Ryan SUBTOTAL $7,647.44
TAX $0.00
TOTAL $7,647.44
ADDITIONAL
GRAND TOTAL
PAYMENT AMT.
PAYMENT TYPE
REF.NO.
Signature Date:
BALANCE DUE
Thank you for your business
Date Printed: 8/20/2015
/�° Carme.1
INDIANA RETAIL TAX EXEMPT PAGE
City ®1Jlr CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
allMiv
Choffift CumGl Pollco Wpaitmont
VENDOR
SHIP 3 CIVIC lBqu@ 2
9809 Country Club Romd TO ftmol, IN 4
Indlainaipollo, IN 46234 (397)579
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-601.00
9 Each water damage repairs $7,647.44 $7,647.44
Sub Total: $7,647.44
(n) .
Send Invoice o: --s
Carmel Pollco DoparkmGnt
Attn: Pact Young
3 CIVIC squaw
Cafmol, IN 462= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT w,w.44
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PARIOF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS TH PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERT P vy THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPRO IAT ON UFFICIENT TO .AY'FOR THE ABOVE'ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL / 1
B
SHIPPING LABELS. IGf o/7 Pollco
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �i7�A•
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO- 3302 0 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
C)
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# I 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
20
Signature
—_— _—_ -- 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))
07/27/15 65885 water damage repairs $7,647.44
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
ChemDry
IN SUM OF $
1601 Country Club Road
Indianapolis, IN 46234
$7,647.44
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
33020 I 65885 I 43-501.00 I $7,647.44 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
Thursday, A gust 20, 2015
4-Z' Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund