319573 12/12/17 a.,
i?� CITY OF CARMEL, INDIANA VENDOR: 369028,,:;=.
r. Q ONE CIVIC SQUARE AQUA FALLS BOTTLED WATER CHECK AMOUNT: $**'*'***30.00-
?Q CARMEL, INDIANA 46032 Po Box 99, CHECK NUMBER: 319573
4"
9�iroHENON•OH 45323 CHECK DATE: 12/12/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4355100 015694 30.00 PROMOTIONAL FUNDS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 369028 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
AQUA FALLS BOTTLED WATER IN SUM OF$ CITY OF CARMEL
PO BOX 98 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.
ENON, OH 45323
Payee
$30.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police 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
015694 43-551.00 $30.00 1 hereby certify that the attached invoice(s),or 12/11/17 015694 monthly payment $30.00
1110 101 1110 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, December 12,2017
ac,--, EN. A.w
Jim Barlow
Chief
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
INVOICE
Aqua Falls Bottled Water Date 11/30/2017
P. 0. Box 98 Invoice#015694
Enon OH 45323-0098
Direct all inquiries regarding this invoice to our accounting department at
937-864-5495
Bill To Ship To
Carmel Police Dept Carmel Police Dept
3 Civic Square 3 Civic Square
Attn: Acts Payable Carmel, IN 46032
Carmel IN 46032
Acct. No.055625
Description Qty Price Charge Payment Balance
Monthly Nov 3@ 10.00 30.00 30.00
M0124062
Invoice Total 30.00
Balance Forward 29.70
Received by:
ACCT. BALANCE 59.70
X