161367 07/11/2008 a CITY OF CARMEL, INDIANA VENDOR: 358385 Page 1 of 1
ONE CIVIC SQUARE GENERAL SHALE BRICK CHECK AMOUNT: $492.50
CARMEL, INDIANA 46032 PO BOX 71917
'ty� i o. CHICAGO IL 60694 -1917 CHECK NUMBER: 161367
CHECK DATE: 7/11/2008
DEPARTMENT ACCO PO NUMBER INV OICE NU MBER AM OUNT D ESCRIPTION
2201 4237000 180808464 492.50 REPAIR PARTS
Ilk
General Shale
Brick MMM
Building The American Dream
#IVf�IC;
Bill To: 279670
CITY OF CARMEL Invoice: 180808464 Invoil Date: 06/26/2008
3400 W 131ST STREET Customer P0: 131 SHELBOURNE SHOP
WESTFIELD IN 46074 -8267
Bill of Lading: 170917696
Goods Issue Date: 06/26/2008
Order: 9466995
Ship -To: Sales Rep: 199
CITY OF CARMEL
3400 W 131ST STREET
Order Loc.: Carmel
WESTFIELD IN 46074 -8267
CARMEL IN
Phone: 317 846 -2566
Car or Truck -No: KEVIN Mode of Shipment: Truck 057
Material Material Description Quantity Price Value USD
Batch Number and Description
6099009662 BRIXMENT TYPE S 50 BAG 9.85 492.50
Subtotal 492.50
TAX
TOTAL 492.50
LATE PAYMENT CHARGE of 1.5°s PER MONTH.
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT
Accnt Customer Name Invoice -Date Invoice Amount Due
279670 CITY OF CARMEL 06/26/2008 180808464 492.50
Remit To: GENERAL SHALE BRICK, INC.
PO Box 71917
CHICAGO IL 60694 -1917
Terms: Take discount of $49.25 If paid on or before 10th of next month.
VOUCHER NO. WARRANT NO.
General Shale and Brick ALLOWED 20
IN SUM OF
P. O. Box 71917
Chicago, IL 60694 -1917
r
$49 2.5 0
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 180808464 42 370.01 $492.!;0 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
Wednesday, July 02, 2008
Street Cort�xv9ssioner
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))
06/26/08 180808464 $492.50
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