210031 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 358402 Page 1 of 1
ONE CIVIC SQUARE I D S
CARMEL, INDIANA 46032 2717 TOBEY DRIVE CHECK AMOUNT: $1,017.80
INDIANAPOLIS IN 46219 CHECK NUMBER: 210031
CHECK DATE: 6/2012012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 124522 1,017.80 OTHER CONT SERVICES
800- 800 -0665 I n v ®I
II)s
317 545 -0670 Fax
1
2717 Tobey Dr. Customer No.: CITCAR -IN
Indianapolis, IN 46219 Invoice No.: 124522
Bill To: City of Carmel Ship To: City of Carmel
3400 W. 131 st Street 3400 W. 131 st Street
Westfield, IN 46074 Westfield, IN 46074
Date S hip Via F.O.B. Terms
05/30/12 Will Call Origin Net 30
I Purchase Order Number Order Date A ccount Re presentative Our Order Number
I 05/30/12 John Heinzelman
Quantit Item Number Description Unit Price l Amount
Re� Shipped B.O.
1.000 1.000 ZRE -6.5 PKG C 6.5 cu ft Blast pot w/ 50' 250.0000 250.00
hose, moisture separator,
Helmet, 41 P2
1.000 1.000 ZRE- D375QH7JD, 375 CFM Portable Diesel Air 300.0000 300.00
Compressor
S/N 71434
1.000 1.000 ZRE -MWC 10% Maintenance Waiver 55.0000 55.00
Two Day Rental
5/30/12 6/1/12
Consumables:
1 1 232 -2145 Airline Filter Replacement 30.7000 30.70
Cartridge Flanged
1 1 77 -1 R .020 Outer Rectangle 14.0000 14.00
50 per pack
30 30 CS20 /40 20/40 Coal Slag 12.2700 368.10
(100 /lbs per bag)
Invoice subtotal 1017.80
Invoice total 1017.80
SEE WARNING ON REVERSE SIDE OF THIS DOCUMENT. THANK YOU FOR YOUR BUSINESS.
VOUCHER NO. WARRANT NO.
ALLOWED 20
IDS Blast
IN SUM OF
2717 Tobey Drive
Indianapolis, IN 46219
$1,017.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 I 124522 I 43- 509.001 $1,017.80 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
F riday June 15, 2012
)0/ ;-r�
Street Commissiop e�
Street CTttie missioner
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))
05/30/12 124522 $1,017.80
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