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175735 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $77.55 CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 175735 LOUISVILLE KY 40285 -6680 CHECK DATE: 8/6/2009 DEPARTMENT ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 0119252823 48.90 09GO119252823 902 4239099 0120223912 3.99 09FO120223912 902 4239099 0121975593 24.66 09FO12197559 Detach this stub and return with your payment ACCOUNT NUMBER PAY BY PAY THIS AMOUNT P.O. BOX 856680 0120223912 7/22/09 3.99 Louisville, KY 40285 -6680 INVOICE NUMBER BILLING DATE AMT. ENCLOSED 09FO120223912 07/04/09 3,9 407201202239128 0000399 00003995 5 ICE MOUNTAIN CARMEL REDEVELOPMENT COMMISION a Division of Nestle Waters North America Inc. SHERRY MIELKE P.O. BOX 856680 111 W MAIN ST STE 140 Louisville, KY 40285 -6680 CARMEL IN 46032 -1905 FOR CUSTOMER SERVICE CALL 1- 800 -472 -9888 FI SIGN UP FOR FREE AUTOPAY! Sign Up Required On Reverse Side. Print Any Changes On Reverse Side. QESP )10:T016:003987:001:1001:ICM11 R 040 91 N 1 D G 01 C EOM ICE MOUNTAIN 3 720806 PAGE 1 OF 1 Z i t o 720806 06/13/09 7/12/09 0960119252823 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 service.icemountai n.com MON- AUG 17 0119252823 III I��I �I II �I 91 ICI III �I II�II�B I IID �I II BSI DI WED- SET 1 THU- OCT 15 5 #BWNNWYR FRI- NOV 13 #0400001192528234# CITY OF CARMEL STREET DEPARTME Customer Service: 1- 800 472 -9888 BONNIE CALLAHAN 3400 W 131ST ST Thank you for choosing Ice Mountain Home Office WESTFIELD IN 46074 -8267 Delivery! We value your business. Introducing NEW NESTEA LEMONADE flavored tea sticks! For a limited time, take $2 off each box of Lemonade, Cit T ea, Mixed Berry, Summer Peach or Tangerine Tea sticks you buy. Call or go online to add to your order. U tt er ends Au t 3i, ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. It's free! Delivery address: CITY OF CARMEL STREET DEPARTME, 2 CIVIC SQ, CARMEL IN 46032 PREVIOUS BALANCE 31.93 6/30 295932 PAYMENT -THANK YOU -31.93 6/17 0625215199 8 5 GAL ICE MOUNTAIN DRK W /HANDLE 27.92 8 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 48.00 7 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -36.00 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 7/12 0630389484 1 OIL /FUEL SURCHARGE 2.00 G7813203 RENT 3.99 TOTAL 48.90 unoW ao� goo O ACCOUNT SUMMARY r PREVIOUS BALANCE PAYMENT /ADJUSTMENT m o 31.93 o� a BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE: of ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 800 472 9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTAIN SPRING WATER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing he later than thirty (30) days after we SAMPLE INN ®IC E sent you the first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter, give its the following information: Your name, address. telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. Describe the error and explain if you can. why you believe there is an error.� You arc obligated to pay the parts of your bill that are not in question. 1234567890 Your Account Number You do not have to pay the disputed amount while it is being investigated. During the investigation, we cannot report your account a as delinquent or take any action to collect the amount in question. On O e4 t CT z34s6789 MONOGr 19 Watch here for a GENERAL INFORMATION WED NOV 1, nE DEG 16 personalized account I. Payments received after the billing (INVOICE) dale will appear on Important Gu,tomel Serrice: 1- 800 <]2.988 II. II���at��tlt llltl' t"' Itlltllatllll .II, 1 Mountain pr"ducH message your next invo Past due invoices (not paid within 30 days of news and m "EY "�I "'9 billing date) may be assessed a late fee as allowed b law not to I°2, u 6 Y offers 1z3 s,,e oy.nale 00006 exceed $20 per month. Additionally, third party collection /attorney l Ub b,. 1, du„, .dl. „6 „1,1 expenses may be assessed at a rate not to exceed IOU /o of the Pay electronically unpaid balance or the maximum allowed by law. T6CrriC ,G CemwnLlm.cmn.Yw can Crtc�kY eauwM"wcFi.TUCM1 "a1tl 0 2. Each returned check is subject to a service charge subject to the a�m�+es.nwe�'•nmW1�ro� r"^�`sa maximum cheek return charge allowable in your State. ;I T Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity ,�,,,w„ ACTIVITY. our AccouNTArn °try amount has been since y ui ment replacement costs will be charged for bottles lost, 0 i;�, Aea, inn "o« 13 Mainst Grs iepp „99 paid i full to 4. E e q P P g� last invoice Y Al stolen, damaged or not returned avoid late fees 5. In accordance with NWNA's Terms and Conditions T &C vour 46189a va 9 6000 oe scuno "gjwrel sonn ware< so 911, 317885/ 5 M"unuin5Gal Deppsil 1.96 Equipment Lease and/or Service Agreement account may be 3n6es, 5 �QM" nminsea,eenm 99 Monthly Oil 091,E 1,78851x144 genll5uicna�9e subject to minimum monthly purchases and /or early cancellation 09n1 318]638611 Surcharge, Fuel fees. (A complete version of the current T &C maybe viewed on the '�a0"' Szw Surcharge or Delivery website listed below) Upon service discontinuation, rent for the rotAE Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. 5°io 6. You will be charged a monthly Oil Surcharge. Fuel Surcharge or M 4AN g° 1A Information') Delivery Fee as described in your T &C. Only one of these fees Payment stub ACCOUNT SUMMARY o o e THI Y PPY BY PAY S AMOUNT will appIN to each account. The fee that applies to your account -,M n�7roR,•���:w,a„P•,mm' ACCOUNTNUMBE0. 57 40 is stated on the front of the invoice. For further information please 1134567890 WW.G DATE MT. ENcEoseo P,A'oIGE NUMK Wimm visit the website listed below or contact our customer service 34 789a center. 7. As a food product, bottled water is subject to the rules and 0,20096307 0rzaz7iz 9 000391049 2009 1 Amount due regulations promulgated by the Federal Food and Drug Imm DOe Administration (FDA). IGEMOUNTM xnRcom,tT y ,,stme 5t 00000 Submit your 8. Your first invoice indicates the products delivered on your first 06 cD5T0ME65T6V ,cECA,E'.enn4j986' payment by this delivery. along with anv applicable bottle and account deposits. L al 6.• I• la. „6n,a,,,la,6t,.u,n 5 a, �.e,.. w•. redemption fees, and any dispenser charges. All future invoices prO6 "E P4.,�e "6e4"�,�o "q°"` date will reflect charges for water delivered and dispenser rental, bottle `�bN„ deposits and credits plus charge, for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of 16 -17 deliveries per year. You will only receive invoices 12 times per year. so approximately 5 of those invoices will reflect two deliveries. Form No. NW 709 5 108 v,/atar Com pany, a Division of Nestle Waters North America Inc. 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)) 07/15/09 09G0119252823 $48.90 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 Ice Mountain IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $48.90 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 09GO119252823 42 389.00 $48.90 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 I 4 hur July 30, 2009 Street Com s oner C +rcea# r'P�.= ^•rr'iSSi9fi9t' Title Cost distribution ledger classification if claim paid motor vehicle highway fund I 720806 6/01/09 6/30/09 09F0120223912 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 g service.1cemountain.com FRI- JUL 17 0120223912 III IIII I III III II III III II I IIIII II II III II MON- AUG 17 WED- SEP 16 #BWNNWYR THU- OCT 15 #0400001202239129# CARMEL REDEVELOPMENT COMMISION Customer Service: 1- 800 -472 -9888 SHERRY MIELKE 111 W MAIN ST STE 140 Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -1905 Delivery! We value your business. Engs Advantage! Ice Mountain Direct now delivers more savings half liter cases than ever. 'Ice Mountain as $4.913 /case. Yes! As low as $�t.5y_a.c"e DELI,) ERED! Cal: MC-4, 2 -9888 cr'vis t ACCOUNT ACTIVITY Pay your bill online at: service. icemountain.com or by phone at: 1-800-472-9888. Its free! Delivery address: CARMEL REDEVELOPMENT COMMISION, 111 W MAIN ST STE 140, CARMEL IN 46032 PREVIOUS BALANCE 21.45 6/07 170708 PAYMENT -THANK YOU -5.97 6/30 295933 PAYMENT -THANK YOU -15.48 6/30 F7702460 RENT 3.99 TOTAL 3.99 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 0 ,ti:,.,.. 21.45 21.45 3.99 3.99 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL, OR FOR I Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WXFFR QUALITY AND INFORMATION. PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL I -800- 472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICE MOUNTA N SPRING WXITR CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. 4216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE HWY., SUITE 4 LOUISVILLE. KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we SAM I NVOI CE sent you the first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter. give as the following information: Your name, address. telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. Describe the error and explain if you can, why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. I zs4sete9 0 T Your Account Number You do not have to pay the disputed amount while it is being 00 /0000 0010010 investigated. During the investigation, we cannot report your account r 123456799 as delinquent or take any action to collect the amount in question. MoNaT 29 Watch here for a GENERAL INFORMATION wE1 DEC TUEDEC ,O personalized account I. Payments received after the billing (I NVOICE) date will appear on Important II,IL „III„ III „IIIIIA,„ 1111 ,I,IIII,.IIIII,.II,.II.I,III eua°ma seNVe: l- Boo- 4]z -98 mesa e your next invoice. Past due invoices (not paid within 30 days of news and billing (late) may be assessed a late fee as allowed law not to t, Y offers ,nN cAy.5,>1e a0000 exceed S20 per month. Additionally. third pant' collection /attorney 11 ..al,a,u 1 a l.ld unpa balance or the maximum allowedtby llw ceed 1110% of the Pay electronically v Each T:e ni�,mc^m.r an neckr ad9c+x�dmom m >u,m«e Each returned check Is subject to a service charge subject to the maximum check return charge allowable in your State. M• Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity I M.�,•,•1•••«"� _'owJwe amount has been ACTIVITY. since your p[C�UNTARWITT ,23 Ma,^ St'"' Cn So 000°0 aid in full to 4. Equipment replacement costs will be charged for bottles lost. l t invoic Ce,v yAddless: mn ^o«. 000°0 p aid stolen, damaged or not returned. P,e+wu,e>I ^ce 4 avoid late fees 5. In accordance with NWNA's Terms and Conditions "TSC" your 08u, 46+898 5 °yme "`-ma ^4t' om 9111 31]80514444 5 G>Ilon Natua Sprin9'A'a e Equipment Lease and/or Service Agreement account may be I lveasw444 s Ice M °4 ^1 ^sc >I Oe^e*�' r� lamseal aewm 1 .99 Monthly Oil 09111 Jt7P8514444 Fuel4SU,c�rSe subject to minimum monthly purchases and/or early cancellation 09 „2 J,B]6JBBn n ^1 Surcharge, Fuel fees. (A complete version of the current TKC may be viewed on the �11I '66dO”] s1 a0 p y Surcharge or Delivery website listed below) Upon service discontinuation, rent for the TorAE Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued TaeNN1." 57A 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or .>I Informa tion") Fee as described in yourT &C. Only one of these fee P a y ment stub ACCOUNT SUMMARY Deliver a °•a f y PAY THIS AMOUNT °�,•e -ore °x °r °�c. e°u will apply to each account. The fee that applies to your account P•,M^' ACCOUNT NUMBER PAY BY 5740 "a,.,� o0 0o ao is stated on the front of the invoice. For further information please 1 214 62890 BRONG OAT MT ENCLOSED IN`]OICE NUMBER 00100/00 visit the website listed below or contact our customer service l na5 6]899 center. 7. As a food product, bottled water is subject to the rules and /420096307 0'1282712619 000391089 z1o9 1 Amount due regulations promulgated by the Federal Food and Drug I n ^oce Administration (FDA). 1cE MOUNrA1N WATER omPANV 323 M 00000 8. Your n first invoice indicates the products delivered o your first K e5iee CyS Submit your �E<AN1.809..]z -9888 ayment by this deliver along with any applicable bottle and account deposits, c^. "gam n,...u.,.u.aa+ E] P," date redemption fees. and any dispenser charges. All future Invoices "1,P e•9 ae, will reflect charges for water delivered and dispenser rental. bottle deposits and credits plus charges for any additional products ordered by vou. Deliveries are made every three or four weeks, for a total of I6 -17 deliveries per year. You will only receive invoices 12 times per year, so approximately 5 of those invoices will reflect two deliveries. 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 5/08 A 720806 ®0 0 6/01/09 6/30/09 09FO121975593 #215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40256 g service. icemountain.com FRI- JUL 17 0121975593 III 1991 1 91191919 19 N III 9 HIII 9 WIN 91 1 199191 MOD- AUG 17 WED- SEP 16 #BWNNWYR THU- OCT 15 #0400001219755935# CARMEL REDEVELOPMENT COMMISION Customer Service: 1- 800 -472 -9888 SHERRY MIELKE 111 W MAIN ST STE 140 Thank you for choosing Ice Mountain Home Office CARMEL IN 46032 -1905 Deliveryl We value your business. F NEW ngs Advantaget Ice Mountain Direct now delivers more savings than ever. Ice Mountain half liter cases as $4.99 /case. Yes! As low as $4. a case DEL IVERED! Cali 800 -472 -9888 or visit 1 ^tlwt�:.CCm /ge"�ll�' -tO take advnntane;nf.0i�r not�I_IOWPI- DricBS— ACCOUNT ACTIVITY Pay your bill online at: service.icemountain.com or by phone at: 1-800-472-9888. Its free! Delivery address: CARMEL REDEVELOPMENT COMMISION, 30 W MAIN ST STE 220, CARMEL IN 46032 PREVIOUS BALANCE 76.55 6/07 170709 PAYMENT -THANK YOU -39.90 6/30 295934 PAYMENT -THANK YOU -36.65 6/17 0625215488 2 5 GAL ICE MOUNTAIN DRK W /HANDLE 11.98 2 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 12.00 1 9 OZ PLASTIC UP 50C /SLEEVE 2.99 2 5 GALLON ICE MOUNTAIN DEPOSIT RETURN -12.00 6/30 0628409641 1 OIL /FUEL SURCHARGE 2.00 F7702623 RENT 6.99 SALES TAX .70 TOTAL 24.66 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT tile t in— ;;le 1 76.55 76.55 24.66 24.66 BILLING RIGHTS SUMMARY YOUR INVOICE 4 WAYS TO HELP US SERVE YOU BETTER IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR DILL, OR FOR 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. A REPORT ON WATER QUALITY AND INFORMATION, PLEASE 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means CALL 1 -800- 472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month's rental. ICI: NIOUNTAIN SPRING RSYfER CO. 3. Kindly fill in the amount enclosed, include your account number on your check, and do not send cash. #216 If you prefer, you can pay your bill online at service.icemountain.com. 6661 DIXIE IIWY., SUITE 4 LOUISVILLE, KY 40258 4. Never hesitate to call us with comments, questions, or concerns. If you think your bill is wrong, or if you need more information about a transaction on your bill, write us on a separate sheet of paper. We must hear from you in writing no later than thirty (30) days after we SAMPLE INVOICE sent you the first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter, give us the following information: Your name, address, telephone and account numbers. Date range of this invoice The dollar amount of the suspected error. Describe the error and explain if you can. why you believe there is an error. You are obligated to pay the parts of your bill that are not in question. 12 34s67a9 0 Your Account Number You do not have to pay the disputed amount while it is being oolooloo- 00100100 investigated. During the investigation, we cannot report your account e :a 12345 as delinquent or take any action to collect the amount in question. rr,a aT O MDN.oa 29 Watch here for a GENERAL INFORMATION w6D Nov n rE. W c11 p ersonalized account I. Payments received after the billing (INVOICE) date will appear on Important Customer SeMce�. t- BUG.a72 -9888 n. n.. dn. an ,ann,t,,,nn,t,mt „,aun.,u,alaau message your next invoice. Past due invoices (not paid within 30 days of news and ...Eyn� ^radm °Inv J°hn D a nd billing date) may be assessed a late fee' as allowed by law not to offers 123­m 51 o exceed $20 per month. Additionally, thud party eollecuon /attorney ty scale Wo it ^II „A6da�,� expenses may be assessed at a rate not to exceed 100% of the unpaid balance or the maximum allowed by law. C0 1. r aayp<L �Meawn` y�9� �0�1� "9 Pay electronically 2. Each returned check is subject to a service charge subject to the ceuKn;ewnr ,�waePiw 0«s.anad,p�hm"<n.. -1 maximum check return charge allowable in your State. Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been since your ACCOUNT A-WITY ACTIVITY. Ewe r ,nMamsueetC11yr5 [e00000 1199 aid in full t0 4. Equipment replacement costs will be charged for bottles lost. last invoice •cel; ynaarea,: bnnooe. 1199 P stolen, damaged or not returned. e.;neasaian<e 42 ns avoid late fees p, ....nxyo9 wa[e� So oo 5. In accordance with NWNA's Terms and Conditions "T &C" your 9 9131 .10. S G a llonNawralsw�n 9 9111 317895 S Mountain SGal Depose[ 196 Equipment Lease and/or Service Agreement account may be 1„ nvw5[.an+ s ke Mn9mabscal Hewn n.99 Monthly Oil subject to minimum monthly purchases and/or early cancellation ovn ne�5 Eeeis"�ma,9e Surcharge, Fuel fees. complete version of the current T &C may be viewed on the .112 1--9 n4o p y Surcharge or Delivery website listed below) Upon service discontinuation, rent for the rorAE Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. I n f ormation”) RMeHI eO..EN[A�m 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or y "1"" 99 99 Deliver Fee as described m y y our T &C. Only one of these fees P a y ment stub ACCOUNT SUMMARY py ie <eo PAY THIS AMOUNT will apply to each account. The fee that applies to your account AccouNr Nu63sEn .o.n oo oar s, 4o �,a7, art .a�l;w�^�^,-- is st ated on the front of the invoice. Ivor further information please tin 123456789D SW G DATE MT. ENCLOSED INVo10E NUMBER ao1 visit the website listed below or contact our customer service 123456 center. 7. As a food product, bottled water is subject to the rules and D92Da96307 141,1i12619 000391049 200° 16 Amount due regulations promulgated by the Federal Food and Drug lohn— Administration (FDA). ICEMOUNraNwATEaoMANr oYS`anes` 8. Your first invoice indicates the products delivered on your first •w^�°^ "�tvw „N Submit your delivery, along with any applicable bottle and account deposits. 1OP �AII� Cp rOMeP5Ewr1<E- fl00 payment by this ai „ial „6 „t,6td..6'u P ^e.••,usia. date redemption fees, and any dispenser charges. All future invoices will reflect charges for water delivered and dispenser rental, bottle s deposits and credits plus charges for any additional products ordered by you. Deliveries are made every three or four weeks, for a total of I6 -17 deliveries per year. You will only receive invoices 12 times per year, so approximately 5 of those invoices will reflect two deliveries. 4 2008 Ice Mountain Spring Water Company, a Division of Nest16 Waters North America Inc. Form No. NW 709 5/06 Q 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. Payee lc P /ev✓7fc� ✓-,7"_ Purchase Order No. PCJ '5 Terms G�d 4 -1 1 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3v b� OyFvI2022. 3�IZ 206 1 �9 0 o 2z_-0y Total 2L 6- S 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 NO. ALLOWED 20 IN SUM OF x ON ACCOUNT OF APPROPRIATION FOR Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or S�2 G9F6 j 2 bill(s) is (are) true and correct and that the yo �/Fo�2�775 5 3 yz X99 2 GG materials or services itemized thereon for which charge is made were ordered and received except 20 0 I n ture Director of pwrations Title Cost distribution ledger classification if claim paid motor vehicle highway fund