170458 04/01/2009 CITY OF CARMEL,.INDIANA VENDOR: T362744 Page 1 Of 1
ONE CIVIC SQUARE JOHN SHURTS CARPET CHECK AMOUNT: $928.66
CARMEL, INDIANA 46032 1813 N FRANKLIN ROAD
INDIANAPOLIS IN 46219 CHECK NUMBER: 170458
on
CHECK DATE: 4/112009
DEPARTMENT ACCOU PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
e1207 4350100 928.66 BUILDING REPAIRS MA
Y
John Shurts Carpet Invoice No.
1813 N. Franklin Road
Indianapolis, IN 46219
C e 11 317) y1�
INVOICE
Customer
Name BToo k s t1 z Q (f- Co So Date
Address Order No.
City H a e w� e l State S ZIP Rep
Phone FOB
Qt Description Unit Price TOTAL
I (05,33 Sc kare 7a ✓cP5 �(ue �Owvi C�f�zfi 3,s"� 78�6�
1 i o -e e 4 W e 4 I sit vi �'on S ((v 5,00
C ll lS''o o 0 0
l r�. 7 (our O P, ep
3d' 0°
OYD @5 f 2x"S hg C I 1 -�rDw,
oHc2
goyuJ lhS�11 m ew l i o�9
C 2x ,'s{:v.� oo,✓,J�1 0
IQ c Ij :nri( SCt( C 4, tom
SubTotal
Payment Details Shipping Handling $0.00
QQ Cash Taxes State
p Check
Q Credit Card TOTAL
Name
CC Office Use Only
Expires
Thank you for your business
�1
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
�7 Purchase Order No.
nJ Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
a
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�p a�- ov 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
20
pnatu�
Xe
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund