190939 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 353874 Page 1 of 1
4 ONE CIVIC SQUARE ROGERS CO OF INDIANA, INC
u 0 CHECK AMOUNT: $139.59
CARMEL, INDIANA 46032 6364 WESTFIELD BLVD
INDIANAPOLIS IN 46220 CHECK NUMBER: 190939
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4238900 36758 139.59 OTHER MAINT SUPPLIES
I IE R S C ®o or Indiana, inc. CUSTOMER 36758
6364 W ESTFIELD BLVD. INDIANAPOLIS, IN 46220 THIS SUP MUST ACCOMPANY INVOICE NO.
PHONE: (317) 255 -3171 www.rog;rspools.net ALL CLAIMS AND RETURNED GOODS
S S NAME
L �n��J�` I
D P ADDRESS
T �L T CITY STATE
O O
DATE SALESMAN CASH REC. ACCT.. SHIP VIA Ppd TERMS CUSTOMER
ORDER NO.
CHARGE RETD. MDSE. D ❑Coll. �e`_ 2
/G DEPT. F.O.B. y
C.O.D.
QUANTITY DESCRIPTION PRICE AMOUNT
zx i D 3 ef
Purchase
Description
G.L.
Budget UL
\r AAA
Line Descr
V'; yeti Purchaser
Approval ate l
s�s�ror
RECEIVED BY
TOTAL
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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.
Terms
353874 Rogers Co. of Indiana, Inc.
6364 Westfield Blvd
Indianapolis, IN 46220
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s)}
139.59
9117110 36758 Tile cleaner
Total 139.59
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
Voucher No. Warrant No.
353874 Rogers Co. of Indiana, Inc. Allowed 20
6364 Westfield Blvd
Indianapolis, IN 46220
In Sum of
139.59
1 ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 36758 4238900 139.59 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
7 -Oct 2010
Signature
139.59 Accounts Payable Coordinator
Cost distribution ledger classification if Title
i
claim paid motor vehicle highway fund