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191570 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 364861 Page 1 of 1 ONE CIVIC SQUARE C S SANDBLASTING AND WELDING LLCC CARMEL, INDIANA 46032 17623 WASHINTON STREET L RECK AMOUNT: $20.00 WESTFIELD IN 46074 e CHECK NUMBER: 191570 CHECK DATE: 11/10/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 4269 20.00 REPAIR PARTS S Sandblasting nd Wel dingy i.LC° 17623 Washington Street Westfield, Indiana, 46074 Phone:(317) 507 -4939 Fax:(317) 867. -6342 Date: 11!3!2010 Invoice 4269 To: city of caffnel Aft. P.O. Job Ref. 1 sandblast oil pan $20.00 2 3 4 5 6 7 8 9 10 Total $20.00 Payment Due upon receipt. After 60 Days Subject To 7% Interest Charge Monthly. Thank you, Charles Stalanaker- Signed: Date: Signed by Customer ;i /v Date: VOUCHER NO. WARRA NO. ALLOWED 20 C S Sandblasting and Welding LLC IN SUM OF 17623 Washington Street Westfield, IN 46074 $20.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT91TITLE AMOUNT Board Member: 2201 4269 42- 370.00 $20.00 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 Friday, No er 05, 2010 5treet Commissioner 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)) 11/03/10 4269 $20.00 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