175809 08/06/2009 a CITY OF CARMEL, INDIANA VENDOR: 355635 Page 9 of 1
t ONE CIVIC SQUARE MIKE'S EXPRESS CAR WASH
CHECK AMOUNT: $144.00
CARMEL, INDIANA 46032 10251 HAGUE ROAD
INDIANAPOLIS IN 46256 CHECK NUMBER: 175809
CHECK DATE: 8/612009
DEPARTMENT A PO NUMBER INVOICE NUMBER AMOUNT D ESCR IPTIO N
2200 4351000 5155 144.00 AUTO REPAIR MAINTEN
Mike's Carwash,lnc. I NVOICE
10251 N.Hague Road
0
�z Indianapolis, IN 46256
INVOICE DATE
Phone: (317) 572 -9250
Fax: (317) 572 -9251 7/11/2009
INVOICE NUMBER
'Email Address: mcw @mail.fwi.com Web Site: http:Nwww,mikescarwash.com 005155
CUSTOMER NUMBER
City of Carmel Police Dept. �S1 I CARPD01
Teresa Anderson
3 Civic Square TERMS
Carmel, IN 46032 Net 30
Des cription QTY UNIT PR ICE AMOUNT
Choice Books 3.00 48.00 144.00
0.40 0.00 144.00
N
RECEIVED o
r Jtl� 2009
CARMEI_
A
w
�,eC1 `1 6 S
Make Checks Payable to: Mike's Car Wash
Attn: Accounts Receivable
10251 N. Haque Road
10f 1 Indianapolis, IN 46256
TotalDue 144.00
Restock/Orde Form
17"
Date:
Billing Address /Location
'Name rL� h on
R
l
Street
rr yLc Ste,
City State Zip /6 0 3 2
Mailing Address
Name
Street
City State Zip
Postage Type (qty Serial Numbers Price Total
Book Cost Gift Card
1 $.63 Express Book
2 $,87 Choice Book z r
3 $1.35 Work Books
4 $1.59 Weekly Wash
Platinum Book
5 $1.84 Gold Book
Orders over $200 Express Single
will be current Choice Single
UPS rate Works Single
Payment Details--,,, Wheel Bright
Clear Coat
Direct Bill Sorry Works
Cash Sorry Free
Old Rewash
Check New Rewash
Credit Card other
Discount
Type (CC): ❑AM ENS MC El DC Subtotal
SIH
Number
TOTAL
Expires (CC)
Signature
Notes
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
Mike's Express Car Wash
Purchase Order No.
10251 N. Hauge Road
Terms
Indianapolis, IN 46256
Date Due
Invoice Invoice Description Amount
Date dumber (or note attached invoice(s) or bill(s))
07/11/09 005155 Car Wash Coupons for Department Vehicles $144.00
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
Mike's F=*PFass GaF Was`' IN SUM OF
10251 N. Hauge Road
Indianapolis, IN 46256
$144.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or
DEPT. INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
5155 E14G R4351000 $144.00 materials or services itemized thereon for
which charge is made were ordered and
received except
3 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund