193078 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00352917 Page 1 of 1
ONE CIVIC SQUARE DOMESTIC UNIFORM RENTAL
CARMEL, INDIANA 46032 3401 COVINGTON ROAD CHECK AMOUNT: $53.20
KALAMAZOO MI 49001
CHECK NUMBER: 193078
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350600 53.20 CLEANING SERVICES
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SOILED PICK UP INFORMATION COPY ANDIOR LINEN DECREASE TICKET
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DOMESTIC UNIFORM RENTAL DOMESTIC UNIFORM RENTAL
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CLERK LOG. NO. MO. DA. YR. OF WK. T.M. t M0: YR. MO YR. MO ➢A. YR. C O.D. EEK
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REPLACEMENT 3 LAST LAST INV
ITEM O ITEM ITEM p ITEM GROSS
't QUANTITY QUAINT QUAN7. WEEK M0. UNIT PRICE FLOOR AMOUNT DATE
(WRITE +R� CODE DESCRIPTION CODE DESCRIPTION QTY. PNG. NVEN. WKLY. i
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COLUMN NAMES NO NEW AMT. OF NEW I
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MIXED SHOP D r.Z STOP ACCOUNT D RT STOP ACCOUNT LOC� DECREASE UNIT PRICE ��iN Q1L °O FOR LINEN OR RL3 TWLS A NO NO. A NO NO, NO O DECREASE CONT. COST 5� 5 6° FOR 3I
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Domestic Linen
IN SUM OF
3401 Covington Road
Kalamazoo, MI 49001
$53.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members
1115 I I 43- 506.00 I $53.20 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
Tuesday, December 14, 2010
Director
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))
12/13/10 I I I $53.20
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