180394 12/16/2009 CITY OF CARMEL, INDIANA VENDOR: 355810 Page 1 of 1
f, ONE CIVIC SQUARE CARMEL AUTO TRUCK SERV.
CARMEL, INDIANA 46032 310 GRADLE DRIVE CHECK AMOUNT: $72.21
CARMEL IN 46032
CHECK NUMBER: 180394
CHECK DATE: 12/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 12526 72.21 AUTO REPAIR MAINTEN
CARMEL AUTO TRUCK SERV.
310 GRADLE DRIVE I n ®i Ce
CARMEL IN 46032
(317) 846 -1171 Number: 12526
Date: December 08, 2009
BILL TO VEHICLE
CARMEL FIRE DEPT 2005 FORD
CARMEL, IN 46032 EXCURSION
VIN# 5ED41912
CONTACT P.O.# MILEAGE
60691
PARTS SERVICES Tax 1 Amount
SERVICE/ /L.O.F 14.00
S -1 OIL FILTER MOTOCRAFT 7.93
S -6 QTS OIL QUAKER STATE 14.28
ROTATE BALACE TIRES 36.00
Sub -Total $72.21
State Tax 6.00% on 0.00 0.00
Total $72.21
VOUCHER NO. WARRANT NO.
ALLOWED 20
Carmel Auto Truck
IN SUM OF
310 Gradle Drive
Carmel, IN 46032
$72.21
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 12526 43- 510.00 $72.21 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 14 2009
v v
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rov. 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))
12526 $72.21
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