301362 07/28/16 i
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CITY OF CARMEL, INDIANA VENDOR: 00352917
® ONE CIVIC SQUARE DOMESTIC UNIFORM RENTAL CHECK AMOUNT: $********39.20*
s. ?a CARMEL, INDIANA 46032 3401 COVINGTON ROAD CHECK NUMBER: 301362
9�'�f;ow.c�� KALAMAZOO MI 49001 CHECK DATE: 07/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350600 0722166605 39.20 CLEANING SERVICES
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VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
DOMESTIC UNIFORM RENTAL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
3401 COVINGTON ROAD IN SUM of$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service .
KALAMAZOO, MI 49001 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$39.20. :.Payee
ON ACCOUNT OF APPROPRIATION FOR
Purchase Order#
Communications Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE#.: Fund# AMOUNT : Board Members DEPT# FUND# (or note attached invoice(s)or.bill(s)) AMOUNT
6722166605 43-506.00 $39.20 1 hereby certify that the attached invoice(s),or 7/22/16 0722166605 $39.20
1115 101 1115 101
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
Tuesday,July 26,2016
-N
Terry Crockett
Director
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
Cost distribution ledger classification if claim paid motor vehicle highway fund.
Clerk-Treasurer
n�1111mm """===IG INV# 0322166605 YOUR LOCAL
D]ME��^��^~O��F��M~�ENTAL3 800-430-0872
MAIN OFFICE
3401 COVINgTON ROAD 269-388-2900 nEL^
KALAMAZOO MI 49001
mi
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