180996 12/30/2009 a CITY OF CARMEL, INDIANA VENDOR: 00352992 Page 1 of 1
ONE CIVIC SQUARE ULTIMATE CARWASH
CARMEL, INDIANA 46032 431 E CARMEL DRIVE CHECK AMOUNT: $395.00
T, ,,�,o �o CARMEL IN 46032 CHECK NUMBER: 180996
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351100 21300 395.00 TICKETS
k S
Ultimate Car Wash
431 E. Carmel Drive
7J114/SS
TMTE
i TOTAL
Ci 0 RETAIL TAX EXEMPT
ty of Carmel CERT NO 003120155 002 0 PAGE 1 Oc 1 PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT 21300
35- 60000972
30NE?CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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. 2(409 car wash tickets
VENDOR Duke's Ultimate Car Wash SHIP City of Carmel Police Department
431 E. Carmel DFive TO 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY 1 UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
75 car washes 395.00
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Send Invoice To: f�-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJEC,T PROJECT ACCOUNT AMOUNT
1110 511 car &leaning PAYMENT
NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
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.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY /4 d/ j f. L; 7 b C, ...4
SHIPPING LABELS. I
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99 ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2130Q CLERK- TREASURER
DOCUMENT CONTROL NO. A.P. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO, ACCT #/TITLE AMOUNT
DEPT. I 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 Stale Board 01 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
Duke's Ultimate Car Wash Purchase Order No. 21300F
431 E. Carmel. Drive Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/18/09 payment for car wash tickets 395.00
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
DukVs Ultimate Car Wash IN SUM OF
431 E. Carmel Drive
Carmel, IN 46032
395.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Pots or INVOICE NO. ACCT #/TITLE AMOUNT hereby certify invoice(s),
DEPT_ I hereb certif that the attached or
21300F 511 3 395.00 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
Assistant Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund