180778 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 00352071 Page 1 of 1
ONE CIVIC SQUARE CLARK APPLIANCE SALES SERVICE CHECK AMOUNT: $519.00
t CARMEL, INDIANA 46032 BB01 BOEHNING LANE
'y roN o INDIANAPOLIS IN 46219 CHECK NUMBER: 180778
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER IN NUMBE AMOUNT DESCRIPTION
2201 4237000 21394 1000260005 519.00 SUB -ZERO FRIDGE REPAI
INVOICE
Delivery Date 12/1612009
8767 Boehning Lane Delivery (3 17) 898 -0135 I- -r-0 Invoice" 60005
Indianapolis, IN 46219 Service (3 17) 890 -9202 Sales Order 2130064
Fax (317) 895 -3161 Customer CARMELSTRE
Customer PO
Salesperson
Coryell, Shawn
GILL TO: ustomer (3 17) 733 -2001 SOLD TO:
Carmel Street Department
Carmel Street Department
3400 West 13 1 st Street 3400 West 131 st Street
Westfield, IN 46074 Westfield. IN 46074
Customer (317) 733 -2001
Model /.Description,/ Serial Brand Qty Unit Price Ext Price Tax
Service for SUBZERO 1 $519.00 $519.00 $0.00
M ode l 690S S 20992
Remit To: SubTotal $519.00
Clark's Sales Service. Inc. Sales Tax $0.00
P.O. Box 44719 Total $519':00
Pay e,ents,- 00
Madison, WI 53744 -4719
`Invoice -Due $5.1 -9 €00
Terms NET 30
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))
12/16/09 1000260005 $519.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Clark Appliances
IN SUM OF
8801 Boehning Lane
Indianapolis, IN 46219
$519.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member:
21394 1000260005 42- 370.00 $519.00 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
Tuesday, December 22, 200E
v y
Street Commissior�er��
Street (fide? missioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund