166351 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 362028 Page 1 of 1
ONE CIVIC SQUARE PREMIUM INSPECTION SERVICES
CARMEL, INDIANA 46032 7605 FOREST DRIVE CHECK AMOUNT: $450.00
FISHERS IN 46036 CHECK NUMBER: 166351
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350900 19487 106200891611 450.00 MOLD INSPECTION
INVOICE
106200891611
SERRVICEE
7605 Forest Dr 317 536 -8369
Fishers, IN 46038
A THE INSPECTION REPORT WILL NOT BE RELEASED UNTIL ALL SERVICES HAVE BEEN PAID IN FULL,
DATE OF INVOICE: October 21, 2008
IQL INSPECTION ADDRESS:
Carmel Clay Parks c/o Terry Myers 1411 E 116th St
Carmel IN 46032
DATE: TYPE OF INSPECTION: AMOUNT:
10/21/2008 Mold Visual Inspection $200.00
3 Mold Samples $250.00
Pumhaw
Descroft
P O 19487 P.O. p c
G.L 0
Budget
Line Deser
Purchaser D
Appro —p�
TOTAL FEES: $450.00
PAYMENTS
CHECK:
CREDIT NOV 0 5 2008
CARD:
EXPIRATION ,BY
SECURITY CODE:
CURRENT ZIP CODE:
SIGNATURE: PAYMENTS:
BALANCE DUE: $450.00
Premium Inspection Services 106200891611
ACCOUNTS PAYABLE VOUCHER
1 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. 19487 F
Premium Inspection Services Terms
7605 Forest Dr
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/21/08 106200891611 A.O. mold inspection 450.00
Total 450.00
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.
Premium Inspection Services Allowed 20
7605 Forest Dr
Fishers, IN 46038
In Sum of
w
450.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
19487 F 106200891611 4350900 450.00 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
17 -Nov 2008
Signature
450.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund