172778 05/27/2009 CITY OF CAR^01EL, INDIANA VENDOR: 057000 Page 1 of 1
ONE CIVIC SQUARE CHARLIES RADIATOR SERVICE INC CHECK AMOUNT: $70.00
CARMEL, INDIANA 46032 740 EAST 106TH ST.
INDIANAPOLIS IN 46280 CHECK NUMBER: 172778
CHECK DATE: 5/27/2009
DEPARTMENT AC COUN T PO NUMBER INVOICE NU MBER AMOUNT DESCRIPTION
2201 4351000 70.00 AUTO REPAIR MAINTEN
R444faz Senuice
74o East 106th Street
Indianapolis. Indiana 46280 r.
844.9452 d
DATE
U 1 YOUR ORDER NO.
SNIP Vla TERm NET 30 DAYS l
.r
MAKE .00 E GUUARANT
V
r-r v THIS RADI
JOB N0. WAS PLUGGED 9c
OCSC MiP V —0,U M1
C LEAN AND REPAIR RADIATOR V
RECO RA D IA TOR
ROC OUT RAD
LEAN AND REPAIR GAS TANK I
REMOVE A ND RE W ATER, PUMP
RECORE HE I
COMPLETE raEW HEATER I
I
REMOVE AND REPLACE RADIATOR
CISCOUNT
THERMOST AND GASKET
PARTS AND MATERIALS
COMPLETE NEW RADIATOR
REMOVE 8 REPLACE GAS TANK' `U
ANTIFREEZE
?E,.IOVE ANO REPAIR THERMOSTAT
'WA
FEDERAL TAX,
STATE TAX
MATERIAL TOTAL
TOTAL r
6 M
f
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))
05/18/09 $70.00
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
Charlie's Radiator Service
IN SUM OF
7 40 E. 106th St.
Indianapolis, IN 462$0
$70.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 43- 510.00 $70.00 E 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
Tljui sday;i� ay 21, 2009
i 7
Street Commissioner
Streat C,, 1- Inau
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund