208266 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 366016 Page 1 of 1
ONE CIVIC SQUARE CJ EDWARDS
CARMEL, INDIANA 46032 579 GRABILL DRIVE CHECK AMOUNT: $229.75
WESTFIELD IN 46074 CHECK NUMBER: 208266
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 1926 229.75 EQUIPMENT REPAIRS M
Attn; CJ Edwards D
579 Grabill Dr ive Invo APR 13 2012
Westfield, IN 46074
(317)847 -0083 Number, 1926
Date. April 12,2012 BY:
Bill To: Ship To;
Lindsay Willard Lindsay Willard
Carmel Clay Parks Recreation Carmel Clay Parks Recreation
Moncrn Community Center donor+ Community Center
12" Centr l Park Drive East :1235 Central Park Drive Fast:
1 5 Carmel, IN 46032 Carmel, IN 46032
4
PO Number Terms code,
net 30
Date Iter1°►.# Description Quantity Price; Tax Amount E
4111112 Maintenance (Shcwit n) 20.00 10= 200,00
Toe clip stop 7,00? 4,25 29 76
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Purchase
Description T ,V N CC 4pn cv�
P.O. P or F F
G.L. 0 4 b 1.'-1341655
Budget t i
Line Descr 0.nn �yt�CtS
Purchaser Date
Approva Date_ l 1Z
Sub-T ota,l $229.75
State Tax 6.00% on b"00 0 00
Total $229.75
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.
366016 Edwards, CJ Terms
579 Grabill Drive
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/12/12 1926 Preventive maintenance 229.75
Total 229.75
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.
366016 Edwards, CJ Allowed 20
579 Grabill Drive
Westfield, IN 46074
In Sum of
229.75
ON ACCOUNT.OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1096 -21 1926 4350000 229.75 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
19 -Apr 2012
Signature
229.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund