251118 11/04/15 j ® 1CITY OF CARMEL, INDIANA VENDOR: 354857
ONE CIVIC SQUARE HOOSIER PORTABLE RESTROOMS INC CHECK AMOUNT: $......**65.00*
:. CARMEL, INDIANA 46032 2201 E 99TH ST CHECK NUMBER: 251 118
INDIANAPOLIS IN 46280 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 11584 65.00 GENERAL PROGRAM SUPPL
�c TtG•tr-� Invoice
License #29-031/33/35 { C-EI v EID
� �� 2201 F. "99th Street Date Invoice #
Ind�anapo6s, I-W"46280 OCT 16 2015 - - - --_--
�fa���
' 10/9/2015 11584
BY:
Bill To:
Customer Phone
573-4026
Carmel Clay Parks Department
Attn: Dawn Koepper
1411 E 116th St Customer Alt. Phone
Carmel, IN 46032 I
P.O. No. Terms Project
PO#XX-2751 Due upon receipt, please. Skate Park
-Item - Service, Dates : :` uanti -- Rate Amount ;
Drop Off October 9, 2015 1 0.001 0.00
Standard Unit(s) Serviced - 5E October 10, 2015 1 65.00! 65.00
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$ 4
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It is a pleasure working with you!
Total $65.00
Office : (317) 844-6919 Payments/Credits $0.00
Email.• hoosierportabtes@gmad corn Balance Due $65.00
'Website: www.h.00sierportahtes.com
L15C`VER'y
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
354857 Hoosier Portable Restrooms, Inc. Purchase Order No.
2201 E. 99th Street Terms
Indianapolis, iN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO#
10/9/15 11584 Portalet for Sk8 Night 10/10/15 Amount
XX2751 $ 65.00
I �
Total $ 65.00
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.
354857 Hoosier Portable Restrooms, Inc. Allowed 20
2201 E. 99th Street
Indianapolis, iN 46280
In Sum of$
$ 65.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
--------------------
PO#or
Dept# INVOICE NO. CCT#/TITL AMOUNT Board Members
1096-60 11584 4239039 $ 65.00 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
October 20, 2015
--------------
Signature
$ 65.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund