172533 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 00351278 Page 1 of 1
ONE CIVIC SQUARE SCHMIDT AUTOMOTIVE CHECK AMOUNT: $277.79
CARMEL, INDIANA 46032 8560 E 30TH STREET
INDIANAPOLIS IN 46219 CHECK NUMBER: 172533
CHECK DATE: 5/1312009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
601 5023990 W08718 277.79 CRANK
QTY. "'r^ PART NO. DESCRIPTION AMOUNT i r /i E. TH STREET
r.✓� INDIANAP 1 IND 95 46219
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NAME
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RESIDENCE PHONE i/ BUSINESS PHQ NE e DEPOSIT
OPR. DESCRIPTION OF W /f AMOUNT
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SPECIAL INSTRUCTIONS LABOR Gi
PARTS
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MATERIAL AND
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WASTE DISPOSAL
TOTAL PARTS ;?-O'7. SUBTOTAL ?�'77
YOUR PL EES MAY AUTHORIZE THE ABOVE REPAIR WORK TO BE DONE ALONG WITH NECESSARY MATE
RIALS..YO ND YOUR EMPLOYEES MAY OPERATE ABOVE VEHICLE FOR PURPOSES OF TESTING, INSPECTION TAX
OR DELIVER T MY RISK. AN EXPRESS MECHANIC'S LIEN IS ACKNOWLEDGED ON ABOVE VEHICLE TO SECURE
THE- AMOUN F REP S THERETO. NOT RESPONSIBLE FOR LOST STOL RTICLES O V ICLES. s PAY THIS
S11 ^NED AMOUNT 7
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Prescribed by State Board of Accounts City Form No. 201 (Rev 199!
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where x
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351278
SCHMIDT AUTOMOTIVE Purchase Order No.
8560 E. 30th St. Terms
Indianapolis, IN 46219 Due Date 5/4/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/4/2009 12385 $277.79
0
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
Date Officer
VOUCHER.# 091718 WARRANT ALLOWED
351278 NEW IN SUM OF
SCHMIDT AUTOMOTIVE
x ,8560 E. 30th St. V o
Indianapolis, IN 46219
R�'�
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
Q
O 12385 01- 6500 -05 $277.79
d�
Voucher Total $277.79
Cost distribution ledger classification if
claim paid under vehicle highway fund