191581 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 353917 Page 1 of 1
ONE CIVIC SQUARE CARMEL SELF STORAGE CENTER
CARMEL, INDIANA 46032 147 W CARMEL DRIVE CHECK AMOUNT: $269.00
CARMEL IN 46032
<<op CHECK NUMBER: 191581
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4353099 26991 269.00 STORAGE FEES
INVOICE
November 1, 2010
Carmel Self Storage Center
147 West Carmel Drive
Carmel, IN 46032
317 -844 -6957
BILL TO: City of Carmel Police Department
3 Civic Square
Carmel, IN 46032
Self storage payment for December, 2010 89.00
8 x 15 unit M -15
Self storage payment for December, 2010 $180.00
10 x 35 unit 4A -1.0
TOTAL $269.00
A INDIANA RETAIL TAX EXEMPT PAGE
C� ®f C arm e 1 R D 1
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 26991
3= CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
EA11 st 3 201C storage
VENDOR Carmel Self Storage Center SHIP Clty of Cannel POlice Department
147 West Carmel Drive TO 3 Civic Oquare
Carmel, IN 46032 Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
monthly payment for stmmage (Oct Dec) 269.00 807.00
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Send Invoice )I
Se Ti:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 530 -99 other rental leases PAYMENT
A/P VOUCHER CANNOT SE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPR PRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
/J .f J
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
CCEPTED ORDERED BY ,l
PURCHASE ORDER NUMBER MUST APPEAR ON ALL l
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
S CLERK TREASURER
DOCUMENT CONTROL No- 2 6 9 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.�_
ALLOWED 20
IN THE SUM OF
f,
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Carmel Self— Storage Center Purchase Order No. 26991F
147 West Carmel Drive Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/4/10 monthly payment 269.00
Total
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.
ALLOWED 20
Carmel Self Storage Center IN SUM OF
147 West Carmel Drived
Carmel, IN 46032
269.00
ON ACCOUNT OF APPROPRIATION FOR
police generla fund
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
26991F 530 -99 269.00 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
November 4 20 10
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund