252601 12/15/15 4%' "''�. CITY OF CARMEL, INDIANA VENDOR: 00350527
ONE CIVIC SQUARE DON'S AUTO TRIM CHECK AMOUNT: $""""1,305.00•
® CARMEL, INDIANA 46032 5397 ROCKVILLE ROAD CHECK NUMBER: 252601
y��roN�°. INDIANAPOLIS IN 46224 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 112765 815.00 REPAIR PARTS
2201 4237000 112766 490.00 REPAIR PARTS
. e
112766
5397 Rockville Road • Indianapolis, IN 46224
(317) 227-0988 Office • (317) 227-0977 Fax
Customer's
Order No. D to /oZ -20/3
20
M / �� e .
Address _
City State ^
SOLD BY CASH C.O.D. ARG ON ACCT. MDSE.REM PAID OUT
QUAN. DESCRIPTION PRICE AMOUNT
1J
.C-
i
ALL CLAIMS AND RETURNED GOODS MUST BE ACCOMPANIED BY THIS BILL
Received By
112765
5397 Rockville Road • Indianapolis, IN 46224
(317) 227-0988 Office • (317) 227-0977 Fax
Customer's _ 2U /��
Order No. Date
Address _
City State
SOLD BY CASH C.O.D. HARGE ON ACCT. MDSE.REM PAID OUT
QUAN. DESCRIPTION PRICE AMOUNT
re-ale, s,,J �--t
17 �r
A.
s
Y `
ALL CLAIMS AND RETURNED GOODS MUST BE ACCOMPANIED BY THIS BILL
Received By
VOUCHER NO. WARRANT NO.
Don's Auto Trim ALLOWED 20
IN SUM OF$
5397 Rockville Road
Indianapolis, IN 46224
$1,305.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
2201 112765 42-370.00 $815.00 1 hereby certify that the attached invoice(s), or
2201 112766 42-370.00 $490.00 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
Thur ay,�fe �' 2015
Str�jt�ePG��hf�Sl�sfd"ner
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))
12/08/15 112765 $815.00
12/08/15 112766 $490.00
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
120
Clerk-Treasurer