169028 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 00351189 Page 1 of 1
ONE CIVIC SQUARE J M SUPPLY
CARMEL, INDIANA 46032 PO BOX 1184 CHECK AMOUNT: $64.40
CARMEL IN 46032
CHECK NUMBER: 169028
CHECK DATE: 2/17/2009
DEPARTMEN ACC OUNT PO N INV OICE NUMBER AMOUNT DESCRIPTION
1120 4238900 16963 64.40 OTHER MAINT.SUPPLIES
n
4 m I
J M Supply Corp INVOICE
Wwsmr PO Box 1184
Carmel, IN 46082 -1184 DATE ORDER NO.
317) 844 -3009 1/29/2009 16963
BILL TO SHIP TO
Carmel Fire Department Carmel Fire Department
2 Carmel Civic Square 2 Carmel Civic Square
Carmel IN 46032 Carmel IN 46032
Att'n. Gary Carter
P.O. NO. TERMS SHIP DATE SHIP VIA FOB VENDOR NO.
VERBAL Net 20 1/29/2009 Our Truck Delivered
ITEM DESCRIPTION QTY UNIT PRICE B/O AMOUNT
7755 -5 Squeegee fixed head w/ locking blade 28" white 2 32.20 0 64.40
Order Complete Total $64.40
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))
16963 Squeegee $64.40
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
VOUrHER NO. WARRANT NO.
ALLOWED 20
J M Supply
IN SUM OF
P.O. Box 1184
Carmel, IN 46032
$64.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #MTLE AMOUNT Board Members
1120 16963 42- 389.00 $64.40 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
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Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund