181165 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 353580 Page 1 of 1
ONE CIVIC SQUARE CUSTOM CAST STONE INC CHECK AMOUNT: $55.00
�,A CARMEL, INDIANA 46032 PO BOX 6069 DEPT 164
a— INDIANAPOLIS IN 46206 -6069 CHECK NUMBER: 181165
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
8 53 5023990 57892 55.00 OTHER EXPENSES
Invoice
I fis;V l .ZA S -t: T OIR Invoice
iRC ht IL( IURAL I.— ;.:nt_t.clAL R. 1, DLN..,..r,\L C5
f F.0 Z 2009 Invoice Date:
Remit Payment To:
(1=_0._Box -6069 Dept 164
LIndianapolis 46206 -6069 Page:
1
(317) 896 -1700
Bill To: Carmel Clay Parks Recreation Ship To:
1411 E. 116th Street
Carmel, IN 46032
Customer ID Invoice Due Date Payment Terms Sales Rep
CARMEL CLAY 01/27/10 Net 30 days Kelly
Ship Via Ship Date Purchase Order No Description
Cust Pick -Up ENGRAVED STONE
Quantity Item Number Description Unit Price Amount
1 ASFL5X12 Address Stone Flat Sealed 55.00 55.00
5" x 12" TO NEAL JANET RANDALL
WITH LOVE, YOUR FAMILY
Subtotal 55.00
1.5% interest per month will be Sales Tax 0.00
added to all invoices not paid Freight 0.00
within 30 days. 0.00
Payment/Credit
Deposit 0.00
THANK YOU FOR YOUR ORDER Total
p urchase E rnemDrcL+1V
Descriptlon
P.O.• 6;?A"7' P c®F
GA. .353 5D133c30
r) rub
Purchaser Date,
APProval. Date DEC 2 9 2009
Ulf:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
353580 Custom Cast Stone Terms
P.O. Box 6069 Dept 164
Indianapolis, IN 46206 -6069
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/28/09 57892 Commemorative stone 22794 F 55.00
Total 55.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
353580 Custom Cast Stone Allowed 20
P.O. Box 6069 Dept 164
Indianapolis, IN 46206 -606
In Sum of$
55.00
ON ACCOUNT OF APPROPRIATION FOR
853 Gift Fund
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
853 57892 5023990 55.00 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
7 -Jan 2010
?V% 7/ 12 M
Signature
55.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund