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193084 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00350432 Page 1 of 1 ONE CIVIC SQUARE EMBROIDERY PLUS CARMEL, INDIANA 46032 5514 W. WASHINGTON STREET CHECK AMOUNT: $8,511.62 INDIANAPOLIS IN 46241 CHECK NUMBER: 193084 CHECK DATE: 12/22/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4356001 112598 8,511.62 UNIFORMS 04/12/2010 11:09 3172432444 DOC PAGE 01 Embroidery Plus Invoice 5514 W Washington St Indianapolis, IN 46241 Date Invoice 12/1612010 112598 Bill To CARNEL FIRE DEFT, 2 CIVIC SQ. CAP,WL, IN 46032 P.O. No- Terms Project Net 30 Item qty Description Rate Amount I B AGS 170 Style #8050-63 Lee&s logo and n=c added 48.00 8,160.00 Shipping lbndl... 351.62 351.62 Saks Tax 0.00% 0-00 Total $8,511,62 VOUCHER NO. WARRANT NO. ALLOWED 20 Embroidery Plus IN SUM OF 5514 West Washington Street Indianapolis, IN 46241 $8,511.62 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department INVOICE NO. ACCT #/TITLE AMOUNT Board Members 24177 112598 43- 560.01 $8,511.62 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 DEC 2 0 2010 xop d D Fire Chief 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)) 112598 $8,511.62 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 1 20 Clerk- Treasurer