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250608 10/21/15 CITY OF CARMEL, INDIANA VENDOR: 364472 ® `I ONE CIVIC SQUARE CARL BREHOB & SON CHECK AMOUNT: $""'*'103.93' ,_� CARMEL, INDIANA 46032 3821 BREHOB ROAD CHECK NUMBER: 250608 M,roH, INDIANAPOLIS IN 46212-3300 CHECK DATE: 10/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4239034 061215 103.93 LANDSCAPING SUPPLIES CARL BREHOB & SON 3821 BREHOB ROAD INDIANAPOLIS, INDIANA 46217-3300 Phone(317)784-1442 ra (!��j f d 8 ?- Fax(317)787-2054 Customer's �../DSL� X11 Order No. V Dat vl 20 M / Address SOLD BY CASH C.O.D. Aq ON ACCT, MDSE.RETD PAID OUT QUANTITY DESCRIPTION PRICE AMOUNT Jpys s All claims and returned goods be acpanledis' Received by TERMS:NET 10 DAYS A 1 Ys%PER MONTH SERVICE CHARG WILL BE CHARGED ON ALL PAST DUE ACCOUNTS. THIS IS AN 18%ANNUALRATE OF;INTEREST. 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)) 06/12/15 $103.93 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 Carl Brehob & Son IN SUM OF $ 3821 Brehob Road Indianapolis, IN 46217-3300 $103.93 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I I 42-390.341 $103.93 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 / edn s ay, ber 14, 2015 Street CommissioK er Rtrppt Commissioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund