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209743 06/18/2012
CITY OF CARMEL, INDIANA VENDOR: 359344 Page 1 of 1 ONE CIVIC SQUARE AYERS BACKFLOW CHECK SERVICE CHECK AMOUNT: $300.00 CARMEL, INDIANA 46032 20 BENNETT ROAD o� `a CARMEL IN 46032 CHECK NUMBER: 209743 CHECK DATE: 6/18/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1093 4350100 81292 300.00 BUILDING REPAIRS MA 081292 MAY 2 9 2012 �"1'ATEi1�ENT DATE _...T RMS TO IN ACCOUNT WITH Ayers Bachow Check Ser. a E. 20 Bennett Rd. 575 -0782; f rz p z� 9 00 2, (Al 2-62-0 ry 2 3o eo 3. n 3 I ©o 5S2-8 /2 00 7 �F 87 I 12 oo 71 14 2" 0 .S. 9173 Z 3� q, Z 9 Z/ 1 X1 00 o s yYSZ 2 3 00 CURRENT OVER 30 DAYS O TOTAL AMOUNT' Madams• DCeat: 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. 359344 Ayers Backflow Check Ser Terms 20 Bennett Rd Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 5117112 81292 Back floww prevention inspections 30800 300.00 Total 300.00 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. 359344 Ayers Backflow Check Ser Allowed 20 20 Bennett Rd Carmel, IN 46032 In Sum of 300.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1093 81292 4350100 300.00 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 14 -Jun 2012 Signature 300.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund