HomeMy WebLinkAbout248990 08/26/15 ,CSN
`� ""F• CITY OF CARMEL, INDIANA VENDOR: 362028
® `ii _ ONE CIVIC SQUARE PREMIUM INSPECTION SERVICES CHECK AMOUNT: $ *""'"250.00'
r. ?� CARMEL, INDIANA 46032 7605 FOREST DRIVE CHECK NUMBER: 248990
+,;,..,_,.='9 FISHERS IN 46038 CHECK DATE: 08/26/15
«ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4350100 511201510084 250.00 BUILDING REPAIRS & MA
INVOICE
5112015100845
PECTj �.; AUG 1 7 2015
f 1i s
By.
7605 Forest Dr 317-536-8369
Fishers, IN 46038
THE INSPECTION REPORT WILL NOT BE RELEASED UNTIL ALL SERVICES HAVE BEEN PAID IN FULL,
DATE OF INVOICE: May 20, 2015
TO: INSPECTION ADDRESS:
Carmel Clay Parks - c/o Dawn Koepper 1235 Central Park Dr E
Carmel IN 46032
DATE: TYPE OF INSPECTION: AMOUNT:
5/20/2015 2 Mold Samples $250.00
TOTAL FEES: $250.00
PAYMENTS Amount Che
CHECK:
CREDIT
CARD: #
EXPIRATION DATE:
SECURITY CODE:
CURRENT ZIP CODE:
PAYMENTS:
SIGNATURE:
BALANCE DUE: $250.00
Premium Inspection Services 5112015100845
Page # 1 of 1
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.
362028 Premium Inspection Services Terms
7605 Forest Dr
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
5/20/15 5112015100845 Mildew testing xx2133 $ 250.00
Total Is 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
Voucher No. Warrant No.
362028 Premium Inspection Services Allowed 20
7605 Forest Dr
Fishers, IN 46038
In Sum of$
$ 250.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#orBoard Members
INVOICE NO. CCT#/TITL AMOUNT
Dept#
1093 511201510084 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
August 20, 2015
Signature
$ 250.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund