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326677 06/29/18
�„y 4�qy JY �• CITY OF CARMEL, INDIANA VENDOR: 372530 • ONE CIVIC SQUARE SMART WASH, LLC CHECK AMOUNT: $*******500.00* s. /tQ CARMEL, INDIANA 46032 1734 OLIVER STREET CHECK NUMBER: 326677 9M��TON G�` WHITING IN 46394 CHECK DATE: 06/29/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4350900 00001 500.00 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 372530 SMART WASH, LLC IN SUM OF$ CITY OF CARMEL 1734 OLIVER STREET 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. WHITING, IN 46394 Payee $500.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Street Department 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 00001 43-509.00 $500.00 1 hereby certify that the attached invoice(s),or 5/21/18 00001 $500.00 2201 2201 2201 2201 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,June 26,2018 Huffman, Dave 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 Smart Wash INVUCE 1734 Oliver St Whiting IN, 46394 Phone: (219)218-7529 INVOICE# DATE 00001 5/21/18 CUSTOMER ID TERMS 106 DUE BILL TO SHIP.TO David Huffman Alex Bajzatt Carmel Street Department Smart Wash 3400 W 131 st Street 1734 Oliver St. Carmel, IN 46074 Whiting IN 46394 (765)252-3009 (219)218-7529 DESCRIPTION QTY UNIT PRICE AMOUNT Large SUV-In and Out + Shampoo 10 50.00 500.00 Thank you for your business! SUBTOTAL 500.00 TAX(7%) TOTAL 500.00 If you have any questions about this invoice, please contact Alex Bajzatt, smartwashowner@gmail.com, 219-218-7529 Invoice Template©2014 Vertex42.com