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176748 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 362830 Page 1 of 1 ONE CIVIC SQUARE GIBBS AUTO INTERIORS, LLC 0 CHECK AMOUNT: $125.00 CARMEL, INDIANA 46032 7201 a asrH STREET INDIANAPOLIS IN 46250 CHECK NUMBER: 176748 CHECK DATE: 9/2/2009 DEPAR TMENT ACCOUNT PO NUMB INVOI N UMBER AMOUNT DESCRIPTION '1120 4351000 3319 125.00 AUTO REPAIR MAINTEN 1 GIEBS AUTO INTERIORS, LLC ?18318 US HWY 31 N Invoice WESTFIELD, IN 46074 Number: 3319 317 -804 -9102 Date: August 19, 2009 Bill To: Ship To: CARMEL FIRE DEPT BOB 2 CIVIC SQUARE 317 -571 -2600 CARMEL, IN 46032 PO Number E-44 Description Taxi Amount SEAT REPAIR 125.00 Sub -Total $125.00 State Tax 7.00% on 0.00 0.00 Total $125.00 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)) 3319 $125.00 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 VOUCHER NO. W ARRANT NO. ALLOWED 20 Gibbs Auto Interiors IN SUM OF r 7201 E. 86th Street Indianapolis, IN 46250 $125.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 3319 43- 510.00 $125.00 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 AUG 3 12009 m Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund