191317 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 00350781 Page 1 of 1
ONE CIVIC SQUARE PICKETT'S PLACE
?o CARMEL, INDIANA 46032 547 E 161ST ST CHECK AMOUNT: $728.00
WESTFIELD IN 46074 CHECK NUMBER: 191317
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 1162 728.00 REPAIR PARTS
PICKETT'S PLACE
547E, MST Invoice Number:
WESMELO, IN 46074 1162
Voice: 317 896 -3271
Invoice Date:
Sold To: Fax: 317 896 -2036 Oct 13, 2010
Page
1
Camel Street Department
3400 West 13'st street
WESMELD, IN 46074
Customer ID Customer PO Shipping Method Payment Terms Due Date
VERBAL Cust. Pickup Net 30th of Next 11/30/10
MiKF L If F AAnnth
Quantity Item Description Unit Price Amount
12.00 STEEL BUSHING 2 -3/8" O.D. 1- 1 /2 "I.D. 19.00 228.00
20.00 STAINLESS STEEL FITTINGS 1- 3116 -12 25.00 500.00
1- 1/16 -16
Subtotal 728.00
Sales Tax
Total Invoice Amount 728.00
Check/Credit Memo No: Payment/Credit Applied
TOTAL 728.00
VOUCHER NO. WARRANT NO.
Pickett`s Place ALLOWED 20
IN SUM OF
547 E. 161st St.
Westfield, IN 46074
$728.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Member:
2201 1162 42- 370.00 $728.00 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
Thursday, October 21, 201C
Street Commissioger
Street uq� iiealoner
Tale
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))
10/13/10 1162 $728.00
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