205187 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00351010 Page 1 of 1
ONE CIVIC SQUARE HALSEN PRODUCTS
CHECK AMOUNT: $149.83
CARMEL INDIANA 46032
PO BOX 877
BELMONT MS 38827 CHECK NUMBER: 205187
CHECK DATE: 115/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356001 0113673 -IN 149.83 UNIFORMS
M et LnvnirP 138.00
=�LesS- Discount 0.00
THANK YOU FOR YOUR ORDER 5 s��Fregt 11.83
z _Sales Tax 0.00_
Invoice Total 149.83
s`
r
s
Less Deposit.` 0.00
149.83
INVOICE�B�`ALANCE
,d -3S -Ti- ✓5 l�..r..
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))
12/16/11 0113673 -IN $149.83
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 N
ALLOWED 20
Halsen Products
IN SUM OF
P. O. Box 877
Belmont, MS 38827
$149.83
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 0113673 -IN 43- 560.01 $149.83 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, January 03, 2012
Street Commiss /ol0&
ft u nis loner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund