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334539 01/18/19 {ur C�qM CITY OF CARMEL, INDIANA VENDOR: 343500 ® ONE CIVIC SQUARE CINTAS CHECK MOUNT: $*******176.20* CARMEL, INDIANA 46032 CINTAS CORPORATION CHECK NUMBER: 334539 PO BOX 631025 CHECK DATE: 01/18/19 CINCINNATI OH 45263-1025 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4239012 5012679126 176.20 SAFETY SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 343500 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER CINTAS IN SUM OF$ CITY OF CARMEL CINTAS CORPORATION An invoice or bill to be properly itemized must show:kind of service,where performed,dates service PO BOX 631025 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CINCINNATI, OH 45263-1025 Payee $176.20 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 5012679126 42-390.12 $176.20 1 hereby certify that the attached invoice(s),or 1/4/19 5012679126 Safety Supplies $176.20 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,January 08,2019 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 CiNrAs,., '- READY FOR THE WORKDAY- SVC/BILLING QUESTIONS: 317-264-5103 REMIT TO: Cintas FAX : 317-644-0870 P.O. Box 631025 PAYMENT INQUIRY : (469)248-4769 CINCINNATI, OH`45263-1025 ROUTE # : LOC #0388 ROUTE 0023 INVOICE PLEASE PAY DIRECTLY FROM THIS INVOICE CARMEL STREET DEPT \ INVOICE # : 5012679126 3400 W 131ST ST DATE : 1/4/19 WESTFIELD, IN 46074-8267 PO # :N/A 317-733-2001 STORE # CUSTOMER # : 0010652787 PAYER # : 0010664222 SVC ORDER # : 8020154298 CREDIT TERMS:NET 30 DAYS MATERIAL # DESCRIPTION QTY UNIT P�IICE EXT PRICE TAX 7235953 Ci vi c Square Garage - Hub 110 SERVICE ACKNOWLEDGEMENT 1 JO.00 I $0.00 UNIT SUBTOTAL) $0.00 7235951 Office Break-room 02548373 110 SERVICE ACKNOWLEDGEMENT 1 $0.00 $0.00 120 CABINET ORGANIZED 1 0.00 $0.00 130 EXPIRATION DATES CHECKED 1 0.00 $0.00 400 SERVICE CHARGE 1 $ 2.95 $12.95 55555 HARD SURFACE DISINFEC SVC 1 6.95 $6.95 55556 DISINFECTANT WIPE 1 0.00 $0.00 111329 ACETAMINOPHEN SM 1 7.77 $7.77 111929 IBUPROFEN TABS SMALL 1 9.06 $9.06 280020. LENS/SCREEN WIPES 100/BX 1 $11.22 $21.22 UNIT SUBTOT $57.95 6633596 MAIN BLD MENS R 02210342 110 SERVICE ACKNOWLEDGEMENT 1 0.00 $0.00 120 CABINET ORGANIZED 1 $1,0.00 $0.00 130 EXPIRATION DATES CHECKED 10.00 $0.00 7. 33129 QUIKHEAL F/P BANDAGES MED 1 $9.23 $9.23 44249 ELASTIC STRIP SMALL 1 $5.15 $5.15 44429 LARGE PATCH 2"X3", MED 1 $�0.45 $10.45 55555 HARD SURFACE DISINFEC SVC 1 6.95 $6.95 55556 DISINFECTANT WIPE 1 L$0.00 $0.00 100039 TRIPLE ANTIBIOTIC OINT SM 1 46.90 $6.90 238000 X3 CLEAN HAND SANITIZER 75 ML 1 7.58 $7.58 UNIT SUBTOT $46.26 6633597 MAINTENANCE BLD 02210497 110 SERVICE ACKNOWLEDGEMENT 1 $0.00 $0.00 120 CABINET ORGANIZED 1 $0.00 $0.00 130 EXPIRATION DATES CHECKED 1 $0.00 $0.00 25552 ZANTAC 150 SM 1 $7.56 $7.56 55555 HARD SURFACE DISINFEC SN'r' 1 $6.95 $6.95 55556 DISINFECTANT WIPE 1 $0.00 $0.00 100039 TRIPLE ANTIBIOTIC OINT SiA 1 $6.90 $6.90 111389 ACETAMINOPHEN MED 1 $12.72 $12.72 111929 IBUPROFEN TABS SMALL 1 $9.06 $9.06 238000 X3 CLEAN HAND SANITIZER 75 ML 1 $7.58 $7.58 280020 LENS/SCREEN WIPES 100/BX 1 21.22 $21.22 UNIT SUBTOTAL $71.99 Page 1 of 2 INVOICE # 501267 126 PAYER # 0010664222 CI READY FOR THE WORKDAY- SVC/BILLING QUESTIONS : 317-264 5103 REMIT TO: Cintas FAX _O : 317-644 0870 P.O. Box 631025 PAYMENT INQUIRY : (469)24 -4769 CINCINNATI, OH 45263-1025 ROUTE # : LOC #03 8 ROUTE 0023 REMIT TO :Cintas SUB-TOTAL $176.20 P.O. Box 631025 TAX $0.00 CINCINNATI, OH 45263-1025 TOTAL $176.20 SIGNATURE : DATE : NAME i I Page 2 of 2 INVOICE # 501267 126 PAYER # 0010664222 i i