187695 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 359344 Page 1 of 1
ONE CIVIC SQUARE AYERS BACKFLOW CHECK SERVICE
'o CARMEL, INDIANA 46032 20 BENNETT ROAD CHECK AMOUNT: $310.00
CARMEL IN 46032 CHECK NUMBER: 187695
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350000 213576 310.00 EQUIPMENT REPAIRS M
P. 213576
INVOICE
SOLD TO: SHIPPED TO:
7 Men Backflow Check Seir.
ADDRESS ADDRESS' 20 Bennett Rd.
7
CITY, STATE, 'ZZIP CITY, STATE, ZIP CAnne
l, IN 46032
CAv4n 575-0789
CUSTOMER'S ORDER SALESPERSON TERMS VIA F.O.B. DATE
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
359344 Ayers Backflow Check Ser Terms
20 Bennett Rd
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/11/10 213576 Backflouv prevention 23685 310.00
Total 310.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1 -6
1 20
Clerk- Treasurer
Voucher No. Warrant No.
359344 Ayers Backflow Check Ser Allowed 20
20 Bennett Rd
Carmel, IN 46032
In Sum of$
310.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. OkCCT #/TITLE AMOUNT Board Members
Dept
1125 213576 4350000 310.00 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
15 -Jul 2010
v
Signature
310.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund