176806 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 359243 Page 1 of 1
ONE CIVIC SQUARE INDY SALT
CARMEL, INDIANA 46032 3490 W 79TH ST CHECK AMOUNT: $518.30
INDPLS IN 46268 CHECK NUMBER: 176806
CHECK DATE: 9/2/2009
DEPARTMENT A P O NUMBER INVOICE N UMBER AMOUNT DES CRIPTION
1120 4236500 1112 518.30 SALT CALCIUM
JC Lasko, Inc c/o Indy Salt Invoice
3490 W 79th St
Date Invoice
Indianapolis, IN 46268
8/18/2009 1112
Bill To
Carmel Fire Department
2 Civic Square
Carmel, IN 46032
Attn: Denise
Description Amount
Morton Rust Remover #40 Delivered to Carmel Fire Dept 106th Shelbourne 518.30
0.00
Phone
Total $518.30
317 -652 -3122
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
I 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))
1112 $518.30
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
Indy Salt
IN SUM OF
3490 West 79th Street
Indianapolis, IN 46268
$518.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 1112 42.365.00 $518.30 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund