184692 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 364105 Page 1 of 1
ONE CIVIC SQUARE C C SUPPLY, LLC
CARMEL, INDIANA 46032 4398 SELLERS STREET CHECK AMOUNT: $200.00
INDIANAPOLIS IN 46226 CHECK NUMBER: 184692
CHECK DATE: 4127/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4236300 IVC52543 200.00 BITUMINOUS MATERIALS
E
7nvoice 1VC52543
C C Supply, LLC
4/19/2010
4398 Sellers Street 4Pa "es
Indianapolis IN 46226 C U P P LY
Fax phone (317) 377 -1227
(317) 377 -1228 Concrete Cont Supply
Bill To: Ship To:
City of Carmel Street Dept City of Carmel Street Dept
3400 W. 131 st ST 3400 W. 131 st ST
Westfield IN 46074 Westfield IN 46074
'kPu[chaseOrder/No.;�v',.,< :,Customer lD"E;�, ?Sales Y§on�ID..,,:•f;, �:Stii in'ylVleth`otl;'���',';�IPa ment�Terms`,{''�
I TYOFCAR MEL ReY'Shi
C 4/19/2010
Orderei.,x.s ,Shi ed fir, BlO a Item9Numtzer, .D'esci 'ton ,fi�..`_;t' lk T., r a Zcoii'nt iUnitPieesEzfP� ice
4 4 0' ZZNI KOLD FLO 5GL PAIL $0.00 $50.00 $200.00
Sabtota t a $200.00
$0.06
$0.00
Frei
Tratle Discounter $0.00
rj r
$200.00
VOUCHER NO., WARRANT NO.
ALLOWED 20
C C Supply, LLC
IN SUM OF
4398 Sellers Street
Indianapolis, IN 46226
$200.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# l Dept. INVOICE NO. ACCT #!TITLE AMOUNT
Board Member
2201 IVC52543 42- 363.00 $200.00 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
o Th`ur'sday r rll 22, 201(
Street Commissioner
Ctrcaf
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts I 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))
04/19/10 IVC52543 $200.00
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