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250719 10/21/15 �C*A �`� `y� CITY OF CARMEL, INDIANA VENDOR: 369970 G.: -� ® ONE CIVIC SQUARE INDIANA BRICK CORPORATION CHECK AMOUNT: $*****6,339.96* s._ CARMEL, INDIANA 46032 734 EAST 169TH STREET CHECK NUMBER: 250719 �,,.,_,.-'? WESTFIELD IN 46074 CHECK DATE: 10/21/15 ` ltUN Gp. DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4236200 80988 6,339.96 CEMENT Indiana Brick Corporation Invoice 734'East 169th Street Invoice Number: Westfield, IN 46074 80988 Invoice late: (317) 896-1600 10/05/15 Pagc: 1 Sold To: Ship To: Carmel Street Department Carmel Street Department 3400 W 131st St 3400«/ 131st St Westfield, IN 46074 Boyd Piercy Westfield, IN 46074 CARMELSTREET Purchase Order Number Terms .-\my Lunn F 5.00%-25th/Net Next EOMI Sales Person ID Shipping Method Shi Date Due Date P ( Bruce L}7on Steve S. 10/05/15 11/30/15 Quantity z Item Number Description Unit Price Amount 5170 19BEL2REGI\fEN" Regimental Full Paver 0.7740 4001.58 21/4x4x8 Chamfered&Lugged 930 19BEI_.2\\%I-IE_\TFII 8x8x2 1/4" \\/heat6eld Paver 2.7000 2511.00 Chamfered 1 DELIP7=?RYCHG DeliveiN Charge 150.0000 150.00 NOT DISCOUNTABLE IS T_1\z\131_.E Deduct$I� .( �� if paid by H 41/�. Please Pay from Invoice. Subtotal 6662.58 Sales Tax 0.00 Check No. Total Due 6662.58 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)) 10/05/15 80988 $6,339.96 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 Indiana Brick Corporation IN SUM OF $ 734 East 169th Street Westfield, IN 46074 $6,339.96 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members 2201 I 80988 I 42-362.001 $6,339.96 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 4 / IVedne/ � d�y, Oqmtw15 Al/I/V V �-/llj1y- 7t- §e.W,t0'-gFmisWq@pr Title Cost distribution ledger classification if claim paid motor vehicle highway fund