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209536 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 363862 Page 1 of 1 ONE CIVIC SQUARE JASON FORCE CARMEL, INDIANA 46032 30 SLEEPY HOLLOW COURT CHECK AMOUNT: $10.00 WESTFIELD IN 46074 CHECK NUMBER: 209536 CHECK DATE: 6/5/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 110708 10.00 REPAIR PARTS DETRO SALES 7080 N. US Highway BAINBRIDGE, IN 46105 (765) 522-6277 CUSTOMER'S ORDER NO. P HONE DATE NA-F :I ADD S CASH C.O.D. CHARGE 71 MDSE. RETD. PAID OUT TAX SOLD BY TOTAL RECEIVED BY C PRODUCT 609 All claims and returned goods MUST be accompanied by th 1 IL 0 7 0 8 DE'M SALES 7080 N US HIGHVVM 231 A BAINBRIDGE, IN 46105 05�24�2012 14:00:06 Merchant ID: 000000001883963 Terminal ID: 02817590 277213556990 CREDIT CARD CARD 9 XXXXXXXXXXXX INVOICE 0004 Batch 000399 Approval Code: 024606 Entry Method: Swiped Mode: Online SALE AMOUNT $10.00 CUSTOMER COPY VOUCHER NO. WARRANT NO. ALLOWED 20 Jason Force IN SUM OF $10.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 I 110708 I 42- 370.00 I $10.00 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 t �o Fire Chief Title 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)) 110708 $10.00 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