208235 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 362296 Page 1 of 1
ONE CIVIC SQUARE CARMEL COUNTERTOPS INC
CARMEL, INDIANA 46032 9043RD AVE, SOUTHWEST CHECK AMOUNT: $5,137.00
CARMEL IN 46032 CHECK NUMBER: 208235
ON
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350100 24322 3854 -12 5,137.00
Carmel Countertops Inc. Invoice
904 3rd Ave. Southwest
Carmel, IN 46032 Date Invoice
3/28/2012 3854 -12
Bill To Ship To
Carmel Fire Dept. Job: station #41
Station 441
P.O. Number Terms Rep Ship Via F.O.B. Project
3854 -12 3/28/2012
Quantity Item Code Description Price Each Amount
Stone top; Contrac... Fabricate and install quartz countertops. 3,423.92 3,423.92
Stone top; Contrac... Quartz, Staron Paula Java. 1 1,713.08
Total $5,137.00
Payments /Credits $0.00
Customer Total Balance $5,137.00
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))
3854 -12 $5,137.00
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
Carmel Countertops, Inc.
IN SUM OF
260 Gradle Drive
Carmel, IN 46032
$5,137.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
24322 I 3854 -12 I 43- 501.00 I $5,137.00 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
APR 2 3 2912
i Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund