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193539 01/05/2011
CITY OF CARMEL, INDIANA VENDOR: 00352992 Page 1 of 1 6 ONE CIVIC SQUARE ULTIMATE CARWASH CARMEL, INDIANA 46032 431 E CARMEL CRNE CHECK AMOUNT: $390.00 CARMEL IN 46032 CHECK NUMBER: 193539 CHECK DATE: 1/5/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 R4351100 27223 390.00 CARWASH TICKE'T'S 'S Vol Ultimate Car Wash 431 E. Carmel Drive l d lJ J —//t DATE TOTAL C� INDIANA RETAIL TAX EXEMPT PAGE Ci o -G r e� PURCHASE OR CERTIFICATE N0. 003120155 002 0 1 D 1 /tom �+�•�a�a DER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 77223 3)ODIF 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. 3 URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION December 22 2010 car wash tickets VENDOR Duke's Ultimate Car Wash SHIP City of Carmel Police Department 431 E. Carmel Drive TO 3 Civic Square Carmel, IN 46032 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT OUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 75 car wash tickets 390.00 Co 111 d ys a itlf` Send invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 511 car cleaning PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. tr^ 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 APPROPRIATION UFFICIENTTO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE XA Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. s a CLERK TREASURER 2 J DOCUMENT CONTROL NO. r 2 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF i ON ACCOUNT OF APPROPRIATION FOR Board Members PO# ar INVOICE NO. ACCT /TITLE AMOUNT nEPT" 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 2© Signature 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 Dukes Ultimate Car Wash Purchase Order No. 27223F 431 E Carmel Drive Terms Carmel, IN 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12/28/10 payment for car washes 390.00 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 V CHER NO. WARRANT NO. ALLOWED 20 u es Ultimate Car Wash V 431 E Carmel Drive IN SUM OF Carmel, IN 46032 390.00 ON ACCOUNT OF APPROPRIATION FOR police general fund Board Members PO#t or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 27223FA 511 390.00 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 e ember 28, 20 10 s Signature Asst. Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund