163256 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 361252 Page I of 1
ONE CIVIC SQUARE INDY CLEAN TEAM LLC
CARMEL, INDIANA 46032 PO sox 4251 CHECK AMOUNT: $470.00
CARMEL IN 46082 CHECK NUMBER: 163256
CHECK DATE: 9/3/2008
DEPARTME AC COUNT PO NUMBER INVOICE NUMBER AM OUNT DE SCRIPTION
1150 4350100 08120 470.00 BUILDING REPAIRS MA
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lady Clean Team, LLC
317 810 -0771
F.O. Box 4251
Carmel, IN 46082
D TE ORDERED ORDER TAKEN BY
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TO PHOE-F30 CUSTOMER ORDER
ADDRESS 108 LOCATION
JOB PHONE STARTING DATE
ATTENTION TERMS
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WORK ORDERED BY
TOTAL LABOR
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CUSTOMER APPROVAL
SIGNATURE TAX'
AUTHORIZED SIGNATUR GRAND TOTAL
NC2817 JOB IN VOIC E
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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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
e Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
W 91K 06/za
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
S
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
-D 69S12- 6) :5,0 1 70� 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
Si tur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund