173385 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 361252 Page 1 of 1
e ONE CIVIC SQUARE INDY CLEAN TEAM LLC CHECK AMOUNT: $285.00
CARMEL, INDIANA 46032 PO sox 4251
CARMEL IN 46082 CHECK NUMBER: 173385
CHECK DATE: 6/10/2009
DEPA ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION
1207 4350600 285.00 CLEANING SERVICES
t
Nancy Mellinger 765 386 -2747 p.2
Indy Clears Team, LLC
317- 810 -0771
P.O. Box 4251
Carmel, IN 46082
DATE ORDERED 1 ORDER TAKEN BY
T i% PHONE NO. CUSTOMER ORDER
JOB LOCATION
JOB FI-IONIIE ST,"-,RTIiVG DATE
ATTENTION TER OS
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DATE ORDEREQ
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DATE C15�',PLETED
FY.!SCEL!_ANEOUS
SUBTOTAL
CUSTOMER APPROVAL
SIGNATURE TAB
AUTHORIZED SIGNATURE GRAND TOTAL
sdams NC2817
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.
11 Payee
f\ Gt U C. sec c, e �t`� l 1��- Purchase Order No.
P-0 a O X gas 1 Terms
acr\"P\ \0 760a oZ Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S& C leCk-r.;C\ s(?-(-\,/ k ce 5 1a0 v
S a u
Total��
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
I n Cl ecxC, (e L�
IN SUM OF
p. o Q x NzS l
C CA- r cr 1 O
ON ACCOUNT OF APPROPRIATION FOR
lac�1 �3rc�vksh
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
0 60O bill(s) is (are) true and correct and that the
1.26-1 d-G6 -cb 16 S ca materials or services itemized thereon for
which charge is made were ordered and
received except
20
S gnature
�i rl Z
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund