190792 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 354857 Page 1 of 1
ONE CIVIC SQUARE HOOSIER PORTABLE RESTROOMS INC CHECK AMOUNT: $600.00
CARMEL, INDIANA 46032 2201 E 99TH ST
INDIANAPOLIS IN 46280 CHECK NUMBER: 190792
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
851 5023990 4116 300.00 OTHER EXPENSES
851 5023990 4117 300.00 OTHER EXPENSES
.�-Coosier Portabfe Restrooms, Inc. Invo
c
License 929- 031/33/35
2201 E. 99th Street Date Invoice
Indianapolis, IN 46280 10/5/2010 4116
Bill To Customer Phone Customer Fax
Carmel Fire Department 317- 409 -3538 317 -571 -2615
Keith Freer
2 Civic Square
Carmel, IN 46032
Project P.O. No. Terms
9/19/09 Public Safety Day Due on receipt please.
Item Service Dates Quantity Rate Amount
Standard Unit(s) Serviced SE Special Community 4 50.00 200.00
non profit rate
Portable liandwashing Station Special Community 2 50.00 100.00
non- profit rate
Total $300.00
Our Phone Our Fax
(317) 844 -6919 (3 17) 844 -8803
r100Sier Porta6Ce Xestrooms, Inc. Invoice
License #29- 031/33/35
2201 E, 99th Street Date Invoice
Indianapolis, IN 46280 10/5/2010 4117
Bill To Customer Phone Customer Fax
Carmel Fire Department 317 -409 -3538 317- 571 -2615
Keith Freer
2 Civic Square
Carmel, IN 46032
Project P.O. No. Terms
9118/10 Public Safety Day Due on receipt.. please.
Item Service Dates Quantity Rate Amount
Standard Unit(s) Serviced SE Special Camnumity 4 50.00 200.00
non -profit rate
Portable Handwashing Station Special Community 2 50.00 100.00
non- profit rate
Total $300.00
Our Phone Our Fax
(317) 844 -691.9 (3 17) 844 -8803
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hoosier Portable Restrooms
IN SUM OF
2201 E. 99th Street
Indianapolis, IN 46280
$600.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. A CT #/TITLE AMOUNT Board Members
1120 4117 $300.00 1 hereby certify that the attached invoice(s), or
1120 4116 $300.00 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
OCT >i 1t 2010
Fire Chief
Title
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))
4117 2010 Safety Day $300.00
4116 2009 Safety Day $300.00
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