192882 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 364940 Page 1 of 1
ONE CIVIC SQUARE K -TECH SPECIALTY COATINGS INC
CARMEL, INDIANA 46032 PO BOX 428 CHECK AMOUNT: $180.08
ASHLEY 1N 46705
CHECK NUMBER: 192862
CHECK DATE: 1 2/1 512 01 0
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4236500 201011 -K0055 180.08 SALT CALCIUM
INVOICE
K -Tech Specialty Coatings, Inc.
P.O. Box 428
Ashley IN 46705
(260) 587 -9113
(800) 854 -5005
FAX (260) 587 -3237
Carmel, City of (IN) Customer. 004227
3400 W. 131 st Street P.O
Carmel IN 46074 Invoke 201011 -KO055
Date 11/30/2010
Pa e 1
a- T s Rate Amount' }a
bate; RTicket #;s Quantrt .Cade:_' Descri lion I
11/30/2010 003475 219.61 BHSEV BEET HEET Severe PICK -UP $0.8200 $180.08
219.61 $180.08
Grand Total: 219.61
Subtotal $1so.oa
A SERVICE CHARGE OF 1 112% PER MONTH, WHICH IS AN Subt 8
ANNUAL PERCENTAGE RATE OF 18 WILL BE ADDED TO Mi 0.00 $0.00
THE UNPAID BALANCE AFTER THE 31ST OF THE MONTH. Frei ht $0.00
Total $180.08
VOUCHER NO. WARRANT NO.
ALLOWED 20
K -Tech Specialty Coatings, Inc.
IN SUM OF
P. O. Box 428
Ashley, IN 46705
$180.08
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO4/Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
2201 201011 -KO055 42- 365.00 $180.08 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/Decgrmlber 10, 2010
Street Commissioner
,51reer uoTitle Issioner
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))
11/30/10 201011 -KO055 $180.08
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