170069 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T0002363 Page 1 of 1
ONE CIVIC SQUARE DAVID PRITCHARD CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 8537 BASH STREET SUITE 7
INDIANAPOLIS IN 46250 -1566 CHECK NUMBER: 170069
CHECK DATE: 3118/2009
DEPARTMENT ACCOUNT PO NU INVOICE NUMB A DESCRIPTION
1207 ^4'463500 62633 150.00 GROUNDS MAINT EQUIPME
0
PLEASE PAY FROM THIS INVOICE
DAVID A. PRITCHARD
D/B/A DAVE SIGMAN PUMP SERVICE
8537 BASH STREET, SUITE 7 INDPLS, IN 46250 PHONE: 849-2505
Finance charge of 1 1 1 2% per month on past due accounts. After 30 days.
"CUSTOMER'Z;O. PHONE DA TE
NAME
ADDRESS
SOLD BY CASH C.O.D. CHARGE ON ACCT. MDSE. RET'D. PAID OUT
QTY. DE CRIPTION PRICE AMOUNT
--J
3--/
AR 1 12009
TAX
RECEIVED BY
TOTAL
C PRODUCT 610 /f,"Ims and ref ed goods must be accompanied by this bill.
62633
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995
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.
n Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total —<Zj, (D
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
6F,-�
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
20
Sign
Cost distribution ledger classification if UTltle
claim paid motor vehicle highway fund