205215 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 355915 Page 1 of 1
ONE CIVIC SQUARE L.T. RICH PRODUCTS INC
CARMEL, INDIANA 46032 920 HENDRICKS DR CHECK AMOUNT: $84.00
LEBANON IN 46052 CHECK NUMBER: 205215
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238000 25802 84.00 SMALL TOOLS MINOR E
LT Rich Products, Inc.
z J4'H' OP L 920 Hendricks Drive �CTS �>NC
Lebanon, IN 46052
IN V OI CE
12/20/2011 25802
Bill To Ship To
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 WEST 131ST ST. 3400 WEST 131ST ST.
CARMEL, IN 46074 CARMEL, IN 46074
USA USA
Date Via
Shop Net 30 1/1912012 12/20/2011 U.S. FedEx Grou
Description Qty Rate Amount
60000 -White AVI -11008 8 9.50 76.00T
FREIGHT Shipping and Handling 1 8.00 8.00T
EXEMPT Sales Tax 0.00% 0.00
Total $84.00
PaymentslGredits $0.00
765 -482 -2040 765- 482 -2050 lauriekiefer @hotmail.com Balance Due $84.00-
VOUCHER NO. WARRANT NO.
ALLOWED 20
LT Rich Products Inc
IN SUM OF
920 Hendricks Drive
Lebanon, IN 46052
$84.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 25802 42- 380.00 $84.00 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
T,ue`sdayiJ,anuary 03, 2012
Street Comm� s ner
Street °��TiiteioDer
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/20/11 25802 $84.00
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