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181612 01/20/2010 a CITY OF CARMEL, INDIANA VENDOR: 363833 Page 1 of 1 1 ONE CIVIC SQUARE MCBETH'S EMBROIDERY SILKSCREEN CARMEL, INDIANA 46032 1015 3RD AVE SW CHECK AMOUNT: $520.00 ,�ro CARMEL IN 46032 CHECK NUMBER: 181612 CHECK DATE: 1/20/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 R4356001 21413 20092378 520.00 SHIRTS McBeth's Embroidery Silkscreen Invoice 1105 3rd.Avenue SW Carmel, IN 46032 Date Invoice 1/6/2010 20092378 Bill To Ship To Carmel Street Dept P.O. Number Terms Rep Ship Via F.O.B. Project 1/6/2010 Quantity Item Code Description Price Each Amount 72 Embroidery client jackets logo and names 7.00 504.00 4 Embroidery logo only 4.00 16.00 Sales Tax 7.00% 0.00 A Vr1 Tata I $520.00 Phone Fax 317- 848 -7313 317 -848 -7315 VOUCHER NO. W.ARRANT NO. ALLOWED 20 McBeth's Embroidery Silkscreen IN SUM OF$ 1105 3rd Ave. S. W. Carmel, IN 46032 $520.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 21413 2009378 43- 560.01 $520.00 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 /f Thur 6ay,�:January 14, 2010 ri Street Commissioner 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 01/06/10 2009378 $520.00 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer