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167021 12/17/2008 CITY OF CARMEL, INDIANA VENDOR: 362296 Page 1 of 1 ONE CIVIC SQUARE CARMEL COUNTERTOPS INC CHECK AMOUNT: $2,500.00 CARMEL, INDIANA 46032 260 GRADLE DRIVE CARMEL IN 46032 CHECK NUMBER: 167021 CHECK DATE: 12/1712008 D EPARTMENT ACCOUNT PO NUMBER INVOICE N UMBER AMOUNT DESCRIPTION 1120 4350100 3107 -08 2,500.00 BUILDING REPAIRS MA I Carmel Countertops Inc. Invoice 260 Gradle Drive Carmel, IN 46032 Date Invoice 12/4/2008 3107 -08 Bill To Ship To Carmel Fire Dept. Station #41 P.O. Number Terms Rep Ship Via F.O.B. Project 3107-08 12/4/2008 Quantity Item Code Description Price Each Amount SS TOP RETAIL Fabricate and install Corian, Aurora, with stainless steel 1,525.00 1,525.00 sink. SS TOP RETAIL Corian Aurora 975.00 975.00 Total $2,500.00 Payments /Credits $0.00 Customer Total Balance $2 i VOUCHER NO. WARRANT NO. ti ALLOWED 20 Carmel Countertops, Inc. IN SUM OF 260 Gradle Drive Carmel, IN 46032 $2,500.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 3107 -08 43- 501.00 $2,500.00 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 15 2008 V —d 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)) 3107 -08 Countertops Sta. 41 $2,500.00 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