201299 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 353637 Page 1 of 1
ONE CIVIC SQUARE L W CONSTRUCTION CO CHECK AMOUNT: $393.00
CARMEL, INDIANA 46032 1132 S RANGELINE ROAD
SUITE 100 CHECK NUMBER: 201299
CARMEL IN 46032
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4239000 28777 81711BB19 393.00 ACCUTAB CHLORIDE TABL
i
f
L W Construction Company, Inc. I nvoice
1132 South Rangeline Road
Suite 100 Date Invoice
Carmel, In. 46032 8/17/2011 081711 -bb19
Bill To Ship To
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATION
1425 E. 116TH STREET 1425 E. 116TH STREET
CARMEL, IN. 46032 CARMEL, IN. 46032
P.O. No. Terms
Courtney Due Upon Receipt
Description Qty Rate Amount
55 lb. pails of PPG Accu -Tab chlorine tablets 3 131.00 393.00
AUG
.t s 2011
d
Purchase
DescriptionC��O� (c3VJ��tS
P.O. P 0 4 C
G.L.
Budget F"
Line Descr
Purchaser Date
aie
Total $393.00
Payments /Credits $0.00
F Balance Due $393.00
Phone Fax
317- 846 -6134 317 -816 -3150
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.
353637 L W Construction Company, Inc. Terms
1132 South Rangeline Rd., Ste 100
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/17/11 81711 bbl Chlorine tablets 28777 393.00
Total I 393.00
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.
353637 L W Construction Company, Inc. Allowed 20
1132 South Rangeline Rd., Ste 100
Carmel, IN 46032
In Sum of
393.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
28777 F 81711 bb19 4239000 393.00 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
8 -Sep 2011
v
i
Signature
393.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund