209628 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00351442 Page 1 of 1
ONE CIVIC SQUARE O'MALIA'S FIREPLACE SHOP, INC
CARMEL, INDIANA 46032 115 MEDICAL DR CHECK AMOUNT: $486.00
CARMEL IN 46032
CHECK NUMBER: 209628
CHECK DATE: 6/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 14105 486.00 REPAIR PARTS
OWALIA'S FIREPLACE OUTDOOR LIVING
115-Medical Drive
CARREL; 04DIANA 46032 14105
(317) 8"-6812 DATE ORDER NO.
TO SHIP TO
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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))
14105 $486.00
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.
O'Malia's Fireplace Outdoor Living ALLOWED 20
IN SUM OF
115 Medical Drive
Carmel, IN 46032
$486.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 I 14105 I 42- 370.00 I $486.00 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
JUN 4 2012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund