187214 07/07/2010 ±�f CITY OF CARMEL, INDIANA VENDOR: 364385 Page 1 of 1
0 ONE CIVIC SQUARE AMERIPAK CHECK AMOUNT: $175.44
CARMEL, INDIANA 46032 PO Box 695
ZIONSVILLE IN 46077-G695 CHECK NUMBER: 187214
CHECK DATE: 7/7/2010
DEPARTMENT ACC PO NUMBER INVOICE NUMBER AMOUNT DESCRIP
2201 4238900 48255 175.44 OTHER MAINT SUPPLIES
`J
INVOICE
w 4
INVOICE NO. ENVOICE DATE PAGE
P.O. Box 695
Zionsville, IN 46077 -0695 "TERMS
Phone: (317) 769 -5511
Fax: (317) 769 -5513
BILL TO: SHIPPEDTO:
CITY OF CAS CITY OP CARL
1
IN IN
us us
ORDER NO. I ORDER DATE CUSTOMER NUMBER LOC. SALESPERSON
40375 06/22/2010 1 I 1
CUSTOMER P.O. NUMBER JOB NUMBER SHIP VIA PPO COL
CITY dF Unknown
QUANTITY ORDERED ITEM NUMBER DESCRIPTION QTY SHIPPED /RETURNED UNIT PRICE DISC EXTENDED PRICE
OTY BACKORDERED
1.00 BD F1848P 1.00 124.4400
FOAM 1/8 X 48 X 550 124.44
PF" 12 4'8 /BDL
1.00 EA 5TI 1.00 39.0000
STAPLER PMIER SWORD PT 39.00
S'VY DLYTY
1.00 3%X STF649 1.00 12.0000
STAPTIBS 3/9" C3AMV FOR STP6 12.00
5000 /BX
U/A
r
SALE AMOUNT MISCELLANEOUS SHIPPING /FREIGHT SALES TAX TOTAL AMOUNT RECEIVED
175.44 .00 .00 12.28 187.72 .00
COMMENTS. BALANCE DUE
7
187.72
VOUCHE NO. WAkRANT NO.
ALLOWED 20
Ameripak
IN SUM OF
P. O. Box 695
Zionsville, IN 46077 -0695
$175.44
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Member;
2201 48255 42- 389.00 $175.44 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
Tlhur! y July 01, 201(
J
St{2tfocrqwn' r W er
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
I
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))
06/22/10 48255 $175.44
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