159207 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 358798 Page 1 of 1
ONE CIVIC SQUARE AMERICAN CLEAN SEAL CHECK AMOUNT: $7,500.00
CARMEL, INDIANA 46032 4469 BRAGDON STREET
INDIANAPOLIS IN 46226 CHECK NUMBER: 159207
CHECK DATE: 5/14/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
X1205 4462000 3157 7,500.00 OTHER STRUCTURE IMPRO
2Y ZD 4
AMERICAN CLEAN SEAL
4469 BRAGDON STREET INVOICE
INDIANAPOLIS, INDIANA 46226
FED. ID. #43- 2014054
(317) 536 -0211
Date: 05/02/08 Inv. No.: 3157
Due Date: 05/12/08 Page No.: 1
Ship To /Remarks
City of Carmel
ATTN: Accounts Payable
One Civic Square
Carmel IN 46032 -2584
REFERENCE TERMS YOUR OUR SALES REP
Net 10 Days MARK
DISC UNIT
REFERENCE DESCRIPTION 1 IT MEASURE EM EXTENDED PRICE
10,000 10,000 PSI Waterblasting per job 1.0 7500.0000 7500.00
Used 10,000 psi spint jet to dean the
fountain floor of dirt, debris and
lightly attached paint.
Job Location: City Center 3rd Ave.
Job Completed: 5-2 -08
Thank You Very Much for your Business
PO# 17568
SUB TOTAL 7500.00
TAX 0.00
TOTAL 7500.00
NET TO PAY 7500.00
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
ran 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
American Clean Seal Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
U'JI %J'r-1 V 3157 %_01VOI III ig of the fo floor of dirt 1, boo. OU
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.
05/12/08 ALLOWED 20
American Clean Seal IN SUM OF
4469 Bragdon Street
Indianapolis, IN 46226
$7,500.00
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 Administration
Board Members
S)or DEPT
NVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
116_6 V 1 bill(s) is (are) true and correct and that the
00 materials or services itemized thereon for
which charge is made were ordered and
received except
20
atuT_ a
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund