180889 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 355635 Page 1 of 1
o, `j. ONE CIVIC SQUARE MIKE'S EXPRESS CAR WASH CHECK AMOUNT: $750.00
1 CARMEL, INDIANA 46032 10251 HAGUE ROAD
;r�od'ab$ INDIANAPOLIS IN 46256 CHECK NUMBER: 180889
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351100 21301 750.00 CAR WASH TICKETS
RII
l Mike's Carwash,lnc. INVOICE
4S r�
10251 N. Hague Road
A Indianapolis, IN 46256 INVOICE DATE
4 Phone: (317) 572 -9250
1 12/17/2009
tom_ Fax: (317) 572 9251
INVOICE NUMBER
Email Address: mcw @mail_fwi com Web Site http 11www.mikescarwash com 005207
CUSTOMER NUMBER
City of Carmel Police Dept. CARPD01
Teresa Anderson
3 Civic Square TERMS
Carmel, IN 46032 Net30
Description QTY UNIT PRICE AMOUNT
Express Books 25.00 32.00 800.00
Discount 1.00 -50.00 -50.00
0.00 0.00 750.00
Make Checks Payable to. Mike's Car Wash
Attn: Accounts Receivable
10251 N. Hague Road
for 1 Indianapolis, IN 46256
Total Due 750.00
INDIANA RETAIL TAX EXEMPT PAGE
C.Irmei. CERTIFICATE NO. 003120155 002 0 l
PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 21301
3m CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
December 16, 2009 car wash tickets
VENDOR Mike's Carwash, Inc. SHIP City of Carmel POiice Department
10251 N. Hague Road TO 3 Civic Square
Indianapolis, IN 46256 Cab¢mel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
25 books Express car wash tickets 30.00 750.00
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City of Carmel Po fie r tnt
Send Invoice To: ATTN: Teresa Anders.
3Civic Square
Carmel, IN 46002
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT r 1 PROJECT ACCOUNT AMOUNT
1110 511 car cleaning ipAYMENT
i' A!P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
f NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. hi. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. i l JAL el PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �LJ .ft.,�
SHIPPING LABELS. 1
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
r••,
CLERK- TREASURER
DOCUMENT CONTROL NO. A COPY SIGN AND RETURN TO CLERK'S OFFICE
VOI.ICHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT APPROPRIATION FOR
Y
Board Members
PO# or INVOICE NO. ACCT #TTITIE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
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
20
Signature
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
Mike's Carwash, Inc. Purchase Order No. 21301F
10251 N. hauge Road Terms
Indianapolis, IN 46256 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/17/09 5207 payment for car wash tickets 750.00
Total
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO..
ALLOWED 20
Mikes' Carwash, Inc.
IN SUM OF$
10251 N. Hague Road
Indianapolis, IN 46256
750.00
ON ACCOUNT OF APPROPRIATION FOR
police generla fund
Board Members
Po# or INVOICE NO. ACC AMOUNT hereby certify I hereb certif that the attached invoice(s), or
21301F 5207 511 750.00 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
December 18 20 09
Signature
Assistanr Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund