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207098 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 051125 Page 1 of 1 ONE CIVIC SQUARE ICE MOUNTAIN SPRING WATER CHECK AMOUNT: $164.10 a CARMEL, INDIANA 46032 PROCESSING CENTER PO BOX 856680 CHECK NUMBER: 207098 LOUISVILLE KY 40285 -6680 CHECK DATE: 3/13/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4350900 5.20 0280121202766 1125 4350900 38.65 02BO120095351 1205 4239099 10.32 0280121776199 2200 4239099 13.46 02BO120048525 2201 4238900 86.15 0280117821082 1701 4239099 7220327048 10.32 12B7220327048 service.icemountainwater.com ®p S E EM IT 215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 02/01/12 02/29/12 02B0120095351 ADDRESS SERVICE REQUESTED Ewa THU MAR 22 0120095351 MON- APR 23 TUE- MAY 22 THU- JUN 21 CARMEL CLAY PARKS AND REC DEPT. Customer Service: 1 -800- 472 -9888 AUDREY KOSTRZEWA Pay your bill online at: service.icemountainwater.com or 1411 E 116TH ST by phone at: 1 -800 -472 -9888. It's free! CARMEL IN 46032 -3455 IIIIIIII "1 "1111'11' 1 1111 'lllll'I'lll'lll'lllll Bang In Sprang! IVow` tl�e °Ut to try st meth�ng new.,t� F a I mited tlmG, enjloy p tof$2 ©ff p on a uartety af'. products,IncI 'Jir g�Sweet�Leaf Teas; San Pellegrtno and S P Sparkling rwt +Beverages Call' 1 $p,Q 72 -9888 C)ffer xplres 4130112. ,,F r,a +er e -s 5 dz.;. ...z gy p. .,y. ,6 .n ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1.800. 472 -9888 or visit service. icemountainwater.com. e Delivery address: P CARMEL CLAY PARKS AND REC DEPT., 1427 E 116TH ST, CARMEL IN 46032 PREVIOUS BALANCE 41.58 2126 345657 PAYMENT -THANK YOU -41.58 2122 0763607728 4 5 GAL ICE MOUNTAIN DIRK W/HANDLE a 15.96 3 9 OZ PLASTIC UP 50C /SLEEVE t 9.87 BOTTLE DEPOSIT 4,CHARGED, 4 CREDITED N R Q 7 201 2 .00 2129 0765794482 1 OIL /FUEL SURCHARGE 2.84 62221846 RENT purchase 9.98 TOTAL a Description ,�ty1� U1CA'Itt PL9St� -IY1 tit 38.65 P.O. A. P or F 1 :..:Budget a LIffe Desc Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 41.58 41.58 38.65 38.65 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. 800472 -9888 OR WRITE US AT: your first invoice will include a pro -rated fee for the current month, plus the next month 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.icemountainwater.com 6661 DIXIE HWY., SUITE 4 LOUISVILLE, ICY 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. 123456PS9 Your Account Number You do not have to pay the disputed amount while it is being 0010W00 oolooroo investigated. During the investigation, we cannot report your account e as delinquent or take any action to collect the amount in question. 1 Moa -oR 7 Watch here for a GENERAL, INFORMATION Y 1VE. afc 18 personalized account I m p ortant 6t1e11tda6411161 »,IIO.61p6.,.1110•,U aJda aao efservice s°0 OZ -9Baa I. Payments received after the billing (INVOICE) date will appear on Inv P Mpenvi pe e a, message your next invoice. Past due invoices (not. paid within 30 days of news and IDenk Yau a "9 fae billing date) may be assessed a late fee as allowed by law not to offers 23 Mal s CrySra� exceed $20 per month. Additionally, third party collectionlattomcy bu.ea LAW-44 expenses may be assessed at a rate not to exceed 100% of the a Sao w. unpaid balance or the maximum allowed by law. v „hya r y v Pay electronically 2. Each returned check is subject to a service charge subject to the 4 maximum check return charge allowable in your State. aal Make sure this 3. All bottle and equipment deposits are shown as CURRENT Activity amount has been ACTIVITY. Since your ACCOUNTAcnVTr MnPreeYClrySate 4. Equipment replacement costs will be charged for bottles lost, last invoice D. r.erynaa Ope' „99 paid in full to stolen, damaged or not returned. avoid late fees Paymem Thank.. v! a 59� 5. In accordance with NWNA's Terms and Conditions "T &C your 9B Y, .1W NavwalsG so o° Mwmam sea, p 29a Equipment Lease and/or Service Agreement account may be rv°es s k•MO a 99 Monthly Oil subject to minimum monthly purchases and/or early cancellation Surchar X113 318,6 „3„ Bm Surchar a Fuel fees. (A complete version of the current T &C may be viewed on the o nx 1 .91 o ot3:rr Surcharge or Delivery website listed below) Upon service discontinuation, rent for the T orn, Fee (see #6 under Leased Equipment is charged through the end of the billing cycle "General in which service is discontinued. w Yn r,eN oax, .......rNr coax s� eo 6. You will be charged a monthly Oil Surcharge, Fuel Surcharge or „N Information' Delive ry Y Fee as described y ed in our T &C. Onl one of these fees Payment stub •,.,,ap o rom Ma y ACCOUNT rUMMAa c yAY TNIS AMOUN will apply m each account. The fee that applies to your account L P AccouNrNUMaEx o A s7- is stated on the front of the invoice. For further information please j$fij69a u,NCOAre N MT.ENCIOBEP e o,E NUMBER WItl01� 1 visit the website listed below or contact our customer service 2,e167M center. 420u9630'7 94262712619 u0a391U11 2004 16 7. As a food pr bottled water is sub ect to the rules and i Amount due regulations promulgated by the Federal Food and Drug i "nn Doe Administration(FDA). icEourrNN wATEa °MVAN± 123 M9n st aN waw o,YSa" oo000 Submit your 8. Your first invoice indicates the products delivered on your first Bs„stoM °BSEfnKr�ArL1-80o-p1968B delivery, along with any applicable bottle and account deposits, a ment b y redemption fees, and an di charges. All future invoices 1W6 ,.t »au» 6 „J6 «�a” ,6c 6a »a P P t this redem P Y p g ucnu° roArn °suroear. so�uowA�;.eors...,ksm. date will reflect charges for water delivered and dispenser rental, bottle deposits and credits plus charges 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. 2008 Ice Mountain Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 709 tt/oa O service.icemountainwater.com V PJJ I "A� A service.icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 02/01/12 02/29/12 0280121202766 LOUISVILLE KY 40258 AS XIE ADDRESS SERVICE REQUESTED I I I I II I �I� THU- MAR 22 0121202766 MON- APR 23 TUE- MAY 22 THU- JUN 21 CITY OF CARMEL PARKS DEPARTMENT Customer Service: 1- 800 472 -9888 MANDY SPADY Pay your bill online at: service.icemountainwater.com or 1411 E 116TH ST by phone at'. 1- 800 472 -9888. It's free! CARMEL IN 46032 -3455 III' lllllllll' llllllllllll 'lll'lllllllll "I'I'll'IIIII'll "11 ,Bring Sprl�ngi IVowthetlmeto =trysometf IIng nevi For`. a Ilmltd ti en�o °y uppto $2 off ona variety of° products t ,dulling S weet Leaf Teas, San Pellegrino, and 8" p Sparkling�~Fruliab erages Cali 1 SOU 472 -9$88 w, g� s •mow m ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472.9888 or visit service. icemountainwater.com. B D el ivery address: CITY OF CARMEL PARKS DEPPMUNON ULNI LK, 1"� UtNI KAL 11ANK DR EAST, CARMEL IN46UJ2 PREVIOUS BALANCE 68.84 2/26 345658 PAYMENT -THANK YOU -68.84 2/22 0763607777 1 -5 L NATURAL SPRING WATER ICE MTN 5.99 5 9 OZ PLASTIC UP 50C /SLEEVE 16.45 7 5 GAL ICE MOUNTAIN DRK W /HANDLE 27.93 BOTTLE DEPOSIT 7 CHARGED, 16 CREDITED -54.00 2/29 0765915772 1 OIL /FUEL SURCHARGE 2 -84 B2295426 RENT Purchase I 1 5.99 TOTAL Description J SIr A L 6 t 5.20 P o`r F P] R a j 2012 r G.L.# �lJ'1� 7(1�C (6V c� r T3 0 Purchaser Date Approval Date ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT /ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 68.84 68.84 5.20 5.20 ISr— to ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 051125 Ice Mountain Terms P.O. Box 856680 Louisville, KY 40285 -6680 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3/2/12 2BO120095351 Drinking water cooler- Maint 38.65 312112 280121202766 Drinking water cooler- MCC 5.20 Total 43.85 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. I 051125 Ice Mountain Allowed 20 P.O. Box 856680 Louisville, KY 40285 -6680 In Sum of 43.85 ON ACCOUNT OF APPROPRIATION FOR 101 General 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 2BO120095351 4350900 38.65 1 hereby certify that the attached invoice(s), or 1091 280121202766 4350900 5.20 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 8 -Mar 2012 Signature 43.85 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund service. icemountainwater.com 215 6661 DIXIE HWY, SUITE 4 02/01/12 02/29/12 02BO121776199 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED WED- MAR 07 0121776199 THU- APR 05 MON- MAY 07 WED- JUN 06 CITY OF CARMEL HUMAN RESOURCES Customer Service: 1- 800 472 -9888 JIM SPELLBRiNG Pay your bill online at: service. icemountainwater.com or 1 CIVIC SQ CARMEL IN 46032 -2584 by phone at: 1- 800 -472 -9888. It's free! Ills' lll' I" I" I" II' tl"" IIIIIIIII 'lllll'lll'llll "�III'lllll'I s RE Sir Bring In Spring! 4Now� s the °time ^to try sotnething new! For =a llmitetl tlrrie, enjoy up to $2 off on a varlety'of roducts tncludin Sweet l.eafi Teas, San�Pelle�'rino ant! S P Sparkiing Frtilt�Beverages Call` 1 800472 "9888 Offer expires=413U /1;2. c4'br` p• x c ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemountainwater.com. Delivery address: CITY OF CARMEL, 1 CIVIC SO, HUMAN RESOURCE DEPT, CARMEL IN 46032 PREVIOUS BALANCE 10.16 2126 345659 PAYMENT -THANK YOU '-10.16 2/06 0761129683 1 5 GAL ICE MOUNTAIN DIRK W /HANDLE 3.49 BOTTLE DEPOSIT: 1 CHARGED,_ CREDITED 00 2129 0765746094 1 OIL /FUEL SURCHARGE 2.84 B2197652 RENT 3.99 TOTAL 10.32 F MAR 12 2012 ey ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT I ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT q Subject to terms on reverse side. 10.16 10.16 10.32 10.32 CHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ountain IN SUM OF CITY OF CARMEL ox 856680 An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by ville, KY 40258 whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. $10.32 Payee J Purchase Order No. ACCOUNT OF APPROPRIATION FOR Terms Administration Department Date Due Invoice Invoice Description Amount Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members Date Number (or note attached invoice(s) or bill(s)) '1 hereby certify that the attached invoice(s), or 03/02/12 02BO121776199 $10.32 )5 0260121776199 42 390.99 $10.32 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 Monday, March 12, 2012 Director, /dministration Title Cost distribution ledger classification if I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance Y claim paid motor vehicle highway fund with IC 5- 11- 10 -1.6 ,20 Clerk- Treasurer service. ice moun tai nwater.com G 215 6661 DIXIE HWY, SUITE 4 02/01/12 02/29/12 1267220327048 LOUISVILLE KY 40258 loggia ADDRESS SERVICE REQUESTED B WED MAR 07 7220327048 THU- APR 05 MON- MAY 07 WED- JUN 06 CITY OF CARMEL OFFICE OF THE CLERK TREASURER Customer Service: 1 -800- 472 -9888 ANN DAVIS Pay your bill online at: service.icemountainwater.com or 1 CIVIC SO by phone at: 1 -800- 472 -9888. It's free! CARMEL IN 46032 -2584 Wit IIII�I� III' I' IIIIIInr�IIIrI 'II Bring NoW !IS the tlme:tta try something newl f=or a Ilmited ttme, enjoy up to $2 off,on a variety of. p IncludingSweetl_eaf Teas, t an f ellegrino andSP Sparkling Frullt Beverages Call 1800-472 9;888. °Offer�eXplreS .4130112; a a e� k <..D -r ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service. icemou ntainwater.com. Delivery address: CITY OF CARMEL, 1 CIVIC SO, CLERK TREASURER OFFICE, CARMEL IN 46032 PREVIOUS BALANCE 16.64 2126 345662 PAYMENT -THANK YOU -16.64 2/06 0761129816 1 5 GAL ICE MOUNTAIN DIRK WIHANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN.„ .00 2129 0765907522 1 OIL/FUEL SURCHARGE 2.84 62233810 RENT 3.99 TOTAL 10.32 ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT 1 ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 16.64 16.64 10.32 10.32 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: mind 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. Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) r t �Jj In. Total 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. I �p ALLOWED 20 V I,�VI� n" IN SUM OF 1) Lt '��l r)T 1o, ?A ON ACCOUNT OF APPROPRIATION FOR Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. 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 20 •S;fgrra�ur Title Cost distribution ledger classification if claim paid motor vehicle highway fund D serviceAcemountainwater.com m 215 6661 DIXIE HWY, SUITE 4 02/01/12 02/29/12 02BO120048525 0 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED WED- MAR 07 0120048525 THU- AP 05 1IMM011 RI HIH II BI HUM N MON- MAY 07 WED- JUN 06 CITY OF CARMEL DEPT OF ENGINEERING Customer Service: 1- 800 -472 -9888 LISA SCOTT OR JUDY STOHLER Pay your bill online at: service. icemountainwater.com or 1 CIVIC CARMEL I 46032 -2584 by phone at: 1- 800472 -9888. It's free! 'll'Ir IIIIIIIIII "II' 11 l l l'll'lllll 'l�II'lll�lllll rz. Bring InSprtng! �low;�ls the ONE ing new! Fora llrt�lted time, enjoy upto$2 off on a uarletyof° products. im uding Sweet Lbeaul as;San Pelleg "rina ;-.A nd S R. Spariclmg Frult Beverages gCalt t-8004472_` 888. Offer a plres &1 61�1�2 F ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1- 800 472 -9888 or visit service.icemountainwater.com. Delivery address: CITY OF CARMEL, 1 CIVIC SQ, CITY ENGINEERING DEPT, CARMEL IN 46032 PREVIOUS BALANCE 20.44 2126 345660 PAYMENT -THANK YOU -20.44 2106 0761129634 1 5 GAL ICE MOUNTAIN DRK WIHANDLE 3.49 1 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT .00 1 5 GALLON ICE MOUNTAIN DEPOSIT RETURN ,Sro78g7 .00 2 9 OZ PLASTIC`;UP 50C /SLEEVE o 5.98 2129 62206002 RENT .0p �y� 3.99 TOTAL 13.46 CITY ENGJNEi R ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT I ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 20.44 20.44 13.46 13.46 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 HIS Constructors, LLC Purchase Order No. 5150 East 65th Street Suite B Terms Indianapolis, IN 46220 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) V28M 2— 5 od Br i dge over M i tehner D Gonstruct $7,220.97 Total 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 Icp Mnaintain IN SUM OF P.O. Box 856680 Louisville, KY 40285 -6680 $13.W ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoi or U43 I NG 4Z39U99 bill(s) is (are) true and correct and that the na materials or services itemized thereon for A cnt 0120048525 which charge is made were ordered and received except 31�2�2 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund fo i f/m, fix, service. icemountainwater.corn p 215 6661 DIXIE HWY SUITE 4 02/01/12 02/29/12 0260117821082 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED e FRI MAR I� I II I II I I I I I I �I I I I I I I I II III 6 0117821082 TUE- APR 1 WED MAY 16 FRI- JUN 15 Customer Service: 1 800 472 9888 CITY OF CARMEL STREET DEPATMENT Pay your bill online at: service. i cemounta i nwater.com or 3400 W 131ST ST by phone at: 1- 800 -472 -9888. It's free! CARMEL IN 46074 -8267 II��I����II' llll' �Il�l�llllllllillllll�lll���llllll 'll'll�ll��lll Bing Ini Sprtngl NORE the' time tortry something new! Por a limited tlme; enjoy Up +to $2 off`nnta �arEety:ofi p`roducts.Inclutlmg�Sweet L eafiTeas, San Pellegrino; andSPSparklingFrU�tBuerages�C all 1 80Q- 4729888 r t3ffer exnl�e4�30t12 ACCOUNT ACTIVITy For questions or a report on water quality and information, call 1 -800- 472 -9888 or visit service. icemountainwater.com. Delivery address: CITY OF CARMEL STREET DEPARTMENT, 3400 W 131TH ST, CARMEL IN 46074 PREVIOUS BALANCE 4.14 2/26 345656 PAYMENT -THANK YOU -4.14 2103 0761852268 3 5 GAL ICE MOUNTAIN DIRK WIHANDLE 10.47 3 5 GALLON ICE MOUNTAIN BOTTLE DEPOSIT 18.00 2 9 OZ PLASTIC UP 50C /SLEEVE 5.98 3 5 GALLON ICE °MOUNTAIN- DEPOSIT RETURN -18.00 2115 0762691913 1 9 OZ PLASTIC UR %50CISLEEVE 2.99 12 5 GAL ICEiMOUNTAIN DIRK WIHANDLE 41.88 12 5 GALLON -ICE MOUNTAIN BOTTLE DEPOSIT 72.00 9 5 GALLONACE MOUNTAIN DEPOSIT RETURN- -54.00 2/29 0765788708 1 OIL/FUEL SURCHARGE 2.84 B2192561 RENT 199 TOTAL 86.15 j ACCOUNT SUMMARY PREVIOUS BALANCE PAYMENT/ ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT Subject to terms on reverse side. 4.14 4.14 86.15 86.15 ISr— VOUCHER NO. WARRAN N ALLOWED 20 Ice Mountain IN SUM OF P. O. Box 856680 Louisville, KY 40285 -6680 $86.15 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 0280117821082 42- 389.00 $86.15 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 Thursday, March 08, 2012 )0/ Street Commission e Street CTitremissioner Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 03/02/12 0280117821082 $86.15 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