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HomeMy WebLinkAbout198570 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CARMEL, INDIANA 46032 PROCESSING CENTER CHECK AMOUNT: $219.74 :o PO BOX 856660 CHECK NUMBER: 198570 LOUISVILLE KY 40285 -6680 CHECK DATE: 6/22/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 60.87 OlEO121202766 1125 4350900 49.56 OlEO120095351 1205 4353099 13.15 OlEO121776199 2201 4238900 0117821082 73.04 OlEO117821082 2200 4239099 0120048525 10.97 OlEO120048525 1701 4239099 01E722032704 12.15 01E7220327048 M I A service. icemountainwater.com 66-011iiiiiieRAM WINDOW 215 6661 DIXIE HWY, SUITE 4 05/01/11-05/31/11 01 EO120095351 LOUISVILLE KY 40258 B e ADDRESS SERVICE REQUESTED MOD- JUN 20 0120095351 WED- JUL 20 THU- AUG 18 MON- SEP 19 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1 -800- 472 -9888 AUDREY KOSTRZEWA Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember, past due accounts are subject to a late fee. CARMEL IN 46032 -3455 Your prompt payment is appreciated. For your l �I ll' I' l llll ll l' I "II "II�I�'I��I���II' convenience, pay online: icemountainwater.com /service. If payment has been made, we thank you. 7;: Refreshing drmksgand3ysav ngsl Fora 1lmited time, en�ay up to $3 off select cases; of Perrier; ;9rtZonatandl SweeteafBeve� ages �Illlithprices this cool, Ming a th Go,to'service cemountalnwater.corr ar call 1 800 72.9888 to add to your next orb !Offer expires .w ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntai nwater.com or by phone at: 1 It's free! Delivery address: P CARMEL CLAY PARKS AND REC DEPT., 1427 E 116TH ST, CARMEL IN 46032 PREVIOUS BALANCE 62.40 5119 0724127360 7 5 GAL ICE MOUNTAIN DRK W/HANDLE 27.93 3 9 OZ PLASTIC UP 50C /SLEEVE 8.97 BOTTLE DEPOSIT: 7 CHARGED, 7 CREDITED .00 5131 0726541113 1 OIL /FUEL SURCHARGE 2.68 E0881931 RENT 9.98 TOTAL 111.96 Purchase P Descrip #ion DN nA I n wotr mn P.O. P orF� G.L.# I ia5 A 13 4�156900 JUN F? 6 1011 Budget Line Descr QgIeE Wrl, Vli^r5 P urchaser Date BY. Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side 62 40 0 00 49.56 111.96 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 800 9888 OR WRITE US AT: your first invoice Will include a pro rated fee for the current month plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer, you can pay your bill online at service. icemountainwater.com 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we SAMPLE INVOICE sent you the first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Your name, address, telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. Describe the error and explain if you can, why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. m +s6]e90 Your Account Number You do not have to pay the disputed amount while it is being 00100100 00100100 investigated. During the investigation, we cannot report your account 123456789 as delinquent or take any action to collect the amount in question. TNR -oa a WN.00T 29 Watch here for a WE6 NOY 71 GENERAL INFORMATION IDE. aEC tB I personalized account message I. Payments received after the billing (INVOICE) date will appear on P 148" ip ;n4atuta,nnnrblp4 „dun.nwnadu a.4«"Brs<m0f' z.9Bae your next invoice. Past due invoices (not paid within 30 days of news and ,",s°u,a. °umanv°6un• billing date) may be assessed a late fee as allowed by law not to offers 123 -m5 in exceed $20 per month. Additionally, third party collection/attorney otY.st+m 00000 I. and a.m.,.,,n r .n .at.w «L.LLWd.a expenses may be assessed at a rate not to exceed 100% of the °T Pay electronically .,.wt. unpaid balance or the maximum allowed by law. 4 r ^t �m�F a°'" 2. Each returned check is subject to a service charge subject to the `"a°,y„rh ,C°"'„ "mo.dN�r�a19di"`vgndm nmua�m°ra. maximum check return charge allowable in our State. °ems B Y Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. since your I V 113 113M+InSIr— Gly. „00000 aid in full to last im�oic 4. Equipment replacement costs will be charged for bottles lost, TxlN.rr� °in -+1.99 P e stolen, damaged or not returned. R r mBa. e•YW 'som avoid late fees 5. In accordance with NWNA's Terms and Conditions "T &C our 4e1e9e W00 Y BM)t 5rylbn Natura SOr nq ui ment Lease and/or Service Agreement account may be nBBS4444 s n ubsOa oEV°Ot 9a q P g Y m nrees'4.+ S beMw nwnsc+lnetum ns9 Monthly 011 E subject to minimum monthly purchases and/or early cancellation °9rn S was °rma.R• Surcharge, Fuel fees. (A complete version of the current T &C maybe viewed on the mm ',„4,.99 R.n )7w g p y Surcharge or Delivery website listed below) Upon service discontinuation, rent for the TOT. Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. c sAS Information 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or Delivery Fee as described in yourT &C. Only one of these fees Payment stub NT SUMMARY pAY TNIS AMOUNT wIII apply to each account. The fee that applies to our account 'AY By PP PP Y p p W "Mm w•"v� ACCOUNT NUMBER 00 00 0 is stated on the front of the invoice. For further information please ,234567890 'RUNG GAT 1234 BER E MI. ENCLOSED IN`7 NUM visit the wcbsitc listed below or contact our customer service ,2)4567890 WINI00 center. 7. As a food product, bottled water is subject to the rules and 0420094307 D4262132419 00039)0 z00� 16 Amount due regulations promulgated by the Federal Food and Drug In^n 00• Administration (FDA). wArE "k;?K avz�.5to0000 8. Your first invoice indicates the products delivered on your first Submit your delivery, along with any applicable bottle and account deposits, Eo+ CNSYOMER SE"' p ayment a ment b this „JL "JL.AI.La.•L "LLLId.a redemption fees, and any dispenser charges. All future invoices t.aad, s M ,w"ao" «sw. date Ncr ur roRTUE.Utoo"n q„UR will reflect charges for water delivered and dispenser rental, bottle deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of 16.17 deliveries per year. You will only receive invoices 12 times per year, so approximately 5 of those invoices will reflect two deliveries. 2008 Ice Mountain Spring Water Company, a Division of Nestl6 Waters North America Inc. Form No. NW 709 11/08 Se service. icemountainwater.com VIT MI service.icemountainwater.com WIM040 !§191 ju 215 6661 DIXIE HWY, SUITE 4 05101/11 05/31/11 01 E0121202766 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED �I����I'I�IIIIIII II I II I!�! I II I II� N 20 0121202766 WEED- JU THU- AUG 18 MON- SEP 19 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1- 800 472 -9888 MANDY SPADY Did you forget about us? Kindly pay upon receipt. 1411 E 116TH ST Remember, past due accounts are subject to a late fee. CARMEL IN 46032 -3455 Your prompt payment is appreciated. For your II I' I III�I�I' I�III� '�'ll'I'�II'I���II��III�IIII'I convenience, pay online: icemountainwater.comiservice. If payment has been made, we thank you. d Refreshing drinks and saxingst For a Ilmited tl,me, enj`oy up.to $3 off select l?errler,ArlZonaand SweetLeafBeveragesW ,thprlces`,thlscool,'brErg an the heat! Coto servPrice :icmoantalnwater.com }orcall 1800.472'98$8foadtl ta�yoarnext °or OfFer expiresmfi1301.11 4& ,z .a a s. a s� .R emu. ACCOUNT ACTIVITY Pay your bill online at: service. icemou ntainwater.com or by phone at:1- 800 -472 -9888. It's free! Delivery address: CITY OF CARMEL PARKS DEPTIMONON CENTER, 1235 CENTRAL PARK DR EAST, CARMEL IN 46032 PREVIOUS BALANCE 61.87 5(19 0724127410 9 5 GAL ICE MOUNTAIN DIRK W /HANDLE 35.91 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 1 .5 L NATURAL SPRING WATER ICE MTN 4.99 BOTTLE DEPOSIT: 9 CHARGED, 8 CREDITED 6.00 5131 0726681281 1 OILIFUEL SURCHARGE 2.00 E0952229 RENT rchase 5.99 Pu 9 mr a TONbcriptiOn' r Y 1WCG sG r m 122.74 P.O. G.L. 1O�1 3�9�0 JUN Q Z Budget fl Llne Desc, c{� 1 i r a te BY Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 61.87 0.00 60.87 122.74 M- ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 051125 Ice Mountain Terms P.O. Box 856 Louisville, KY 40285 -6680 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 6/2/11 1 EO120095351 Drinking water cooler -Mai nt 49.56 6/2/11 1 EO121202766 Drinking water cooler- MCC 60.87 Total 110.43 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 Voucher No. Warrant No. 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285 -6680 In Sum of 110.43 ON ACCOUNT OF APPROPRIATION FOR 101 General 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 lEO120095351 4350900 49.56 1 hereby certify that the attached invoice(s), or 1091 1 EO121202766 4350900 60.87 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 16 -Jun 2011 Signature 110.43 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund sery ice.icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 05/01/11 05/31/11 01 EO120048525 LOUISVILLE KY 40258 E e e ADDRESS SERVICE REQUESTED �I��llllll II�I�IIIII II �I III�I I II� N 24 0 120048525 TUE- JU WED- AUG 24 FRI- SEP 23 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1 800 472 9888 LISA SCOTT OR JUDY STOHLER Did you forget about us? Kindly pay upon receipt. 1 CIVIC SQ Remember, past due accounts are subject to a late fee. CARMEL IN 46032 -2584 Your prompt payment is appreciated. For your I���L �IIIIIII II��I��I '���'I'� "I'�'�III'�I'lll convenience, pay online: icemountainwater.com /service. If payment has been made, we thank you. Refreshing dunks and savings! Fora llmltediffiWC en oy up to $3 off select4cases�of rer..rler, ArlZona anrt Sweet Leaf'Bevera s Wlfh Aces, thls crol bring cinthe�heatf Go to serviceicemountatnwater:com or calf 3 1 =60�- 472= 98$8to add�to your next order! Offer expires 613011'1 uk. r s ACCOUNT ACTIVITY Pay your bill online at: service.icemountainwater.com or by phone at:1 -800 -472 -9888: It's free! Delivery address: CITY OF CARMEL, 1 CIVIC SO, CITY ENGINEERING DEPT, CARMEL IN 46032 PREVIOUS BALANCE 20.94 5/25 0725101521 2 5 GAL ICE MOUNTAIN DIRK WIHANDLE 6.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 2 5 GALLON ICE MOUNTAIN DEPOSIT.RETURN .00 5/31 E0867734 RENT 7 7 3.99 TOTAL+ 31.91 a -a .1 v Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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. —fi I Payee E ce r,) Purchase Order No. Terms lU�Cu Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) DJ-6 25 Total 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 VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or Nok Q IE G 10.q 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 20 i 9 Cost distribution ledger classification if Title claim paid motor vehicle highway fund service.icemountainwater.com o D 0 am AT 215 6661 DIXIE HWY SUITE 4 05/01/11 05/31/11 01 EO117821082 LOUISVILLE KY 40258 e e ADDRESS SERVICE REQUESTED FRI- JUN 17 �I�'��IIIII��I (II�III II I���III �II 0117821082 TUE- JUL 19 WED- AUG 17 FRI- SEP 16 Customer Service: 1 800 472 9888 CITY OF CARMEL STREET DEPATMENT Did you forget about us? Kindly pay upon receipt. 3400 W 131ST ST Remember, past due accounts are subject to a late fee. CARMEL IN 46074 -8267 Your prompt payment is appreciated. For your l l IIII' �I� ll "'lll convenience, pay online: icemountainwater.com /service. If payment has been made, we thank you. Refreshing drinks and savings!'For a limited time, enjoy up to $3 off select cases of Peh ier; Ai•iZona-and Sweet Leaf Beverages. With prices .this cool, bring on the heat! Go to service. icemountainwater..com or.call 1- 800 472 -9888 to add t your ne xt- orderl Offer expires 6/3 0/11. ACCOUNT ACTIVITY Pay your bill online at: service. icemountainwater.com or by phone at: 1 -800-472-9888. It's free! Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074 PREVIOUS BALANCE 14.45 5/18 0723804209 2 9 OZ PLASTIC UP 50C /SLEEVE 3.98 11 5 GAL ICE MOUNTAIN DIRK W /HANDLE 38.39 11 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 66.00 7 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -42.00 5/31 0726534407 1 OIL /FUEL SURCHARGE 2.68 E0854919 RENT 3.99 TOTAL 87.49 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse s8 14.45 0.00 73.04 87.49 VOUCHER NO. WARRANT NO. ALLOW ED 20 Ice Mountain IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $73.04 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# /Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 2201 01 E0117821082 42- 389.00 $73.04 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 Tlliursday' ne 16, 2011 Street Commissia4e Ctrapt �nmrnisginr cr 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)) 06/02111 01 E0117821082 $73.04 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 Al TITA ";A service] cemountainwater.corn 215 6661 DIXIE HWY, SUITE 4 05/01/11 05/31/11 01117220327048 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 310111-11my 01, N 24 7 220327048 TUE- JU WED- AUG 24 FRI- SEP 23 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1 472 9888 ANN DAVIS Thank you for choosing Ice Mountain Home Office 1 CIVIC SQ Delivery! We value your business. CARMEL IN 46032 -2584 rllnlll! r i l nrr l l lur lll l Il r rinlllilrl��l 'Ilrinrllrllll�ll Ref�eshrng drinks and savings! i=or a I�mifed timeen;Ioy up to $3 off select cases of Pewter, ArtZona°and Sweet L° eafBeve "rages::Wittlprices;thgis cool, bring on:fh; heat! Go toserrrice icemountainwater com= orcaft r1 80p- 47,2 9888 to add to yournext order! Offer expires.; 6 /3011 1. I s" t ACCOUNT ACTIVITY Pay your bill online at: service. icemounta inw ater.com or by phone at:1- 800- 472 -9888. It's free! Delivery a ress: GITY OF CARMEL, 1 CIVIC; SQ, CLERK TREASCREK OFFICE, CARMEL IN 46032 PREVIOUS BALANCE 9.50 5120 864936 PAYMENT -THANK YOU -9.50 5125 0725101893 1 9 OZ PLASTIC UP 50C /SLEEVE 1.99 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT:..... .00 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN,.. .00 5/31 0726674658 1 OILIFUEL SURCHARGE 2.68 E0893568 RENT 3.99 TOTAL 12.15 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 9.50 9.50 12.15 12.15 Prescribed by state Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 ill(s)) W 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. ALLOWED 20 IN SUM OF 76 5 W�V L U f),(5 ON ACCOUNT OF APPROPRIATION FOR LI �s- Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 1 hereby certify that the attached invoice(s), or E S 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 20 Signature Cost distribution ledger classification it Title claim paid motor vehicle highway fund 11641;1 114 service.!cemountainwater.cam 215 6661 DIXIE HWY, SUITE 4 05/01/11 05/31/11 01 E0121776199 0 LOUISVILLE KY 40258 e ADDRESS SERVICE REQUESTED II I I �I II I IIII I II'�I I I I I 1 I I I I I I� II� TUE- JUL I 26 0121776199 WED- AUG 24 FRI- SEP 23 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888 JIM SPELLBRING Thank you for choosing Ice Mountain Home Office 1 CIVIC SO Delivery! We value your business. CARMEL IN 46032 -2584 Illlll�r��ll��llll��' lllrlll��lllllllrl�lrrll "IIIIII�II�IIIIII�I p ff 3' Refreshing drinks and sa�ingslFora Ilm�ited time, enjoy up to$3 of# select cases ofPerner, rlona and Sweet Leaf Beverages: With pnces`thts cool tblririg onthe heat+ Go to service icenountainw er.cam ©r call 180029888 to a,dd4ta your nextordert� ,(affer��xpires= 8130��11� ACCOUNT ACTIVITY Pay your bill online at: service. icemountainwater.com or by phone at: 1- 800-472 -9888. It's free! MINNOW e e e Delivery address: CITY OF CARMEL, 1 CIVIC SO, HUMAN RESOURCE DEPT, CARMEL IN 46032 PREVIOUS BALANCE 3.50 5125 0725101612 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49 BOTTLE DEPOSIT: 1 CHARGED, 1 CREDITED .00 5/31 0726485675 1 OIL /FUEL SURCHARGE 2.68 E0859729 RENT 3.99 TOTAL 16,65 JUN 20 I By l ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT '�S Subject to terms on reverse side. 3.50 0.00 13.15 e 16.65 VOUCHER NO. WARRANT NO. ALLOWED 20 Ice Mountain IN SUM OF PO Box 856680 Louisville, KY 40258 $13.15 ON ACCOUNT OF APPROPRIATION FOR Carmel Administration PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1205 01E0121776199I 43- 530.99 $13.15 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 Monday, June 20, 2011 Director, A ministrati 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)) 05/31/11 01 E01 21 7761 99 $13.15 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