180890 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 00351342 Page 1 of 1
ONE CIVIC SQUARE MIRROR CONCEPTS, INC
J CARMEL, INDIANA 46032 CHECK AMOUNT: $252.34
�i. CA 3RD
4 C ARMEL IN 46032 CHECK NUMBER: 180890
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1 .902 4460931 17714 252.34 CHAOS
(iiRR T u Copy
Inc. Concepts, Inc. I N V 0
Since 1983
950 3rd Avenue, S.W. Carmel, Indiana 46032
2 (317) 843 -1204 FAX (317) 843 -8335 Page 1
CAR035
Sold To: CARMEL REDEVELOPMENT CENTER Ship To: 37 W. MAIN STREET
Date Rep ID Order No. Ord Date Ship Via Terms Inv No.
12/04/09 JR 00001939 C.O.D. 00017714
Item /Description Quantities Units Price Amount
Ordered 1.0000
37 W MAIN STREET Shipped 1.0000 .0000 .00
FRONT DOOR Ordered 1.0000
1- 23 7/8 X 59 7/8 Shipped 1.0000 252.3400 252.34
THANK YOU MIRROR CONCEPTS
Subtotal 252.34
Non Taxable Taxable Sales Freight Mist Invoice Total
.00 252.34 /7. 6 .00 .00 270.00
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
H/ vim✓ Co•7c A-7 Purchase Order No.
/i Terms
J
32 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
t 9 77i 6 .7s 2 3f`
Total 2 s2.3f
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
t7 �r e 4�ra 7 G✓ r IN SUM OF
.5<.9 3 sue`
252 37
ON ACCOUNT OF APPROPRIATION FOR
�1i2�`7`i'G 9 3/
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT hereby certify I hereb certif that the attached invoice(s), or
2 /77/7 2 7 /1 7 1 693/ 252 3y 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
/2— 2 20
Si na-ure
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund