210604 07/06/2012 CITY OF CARMEL, INDIANA VENDOR: 359344 Page 1 of 1
s. ONE CIVIC SQUARE AYERS BACKFLOW CHECK SERVICE
CARMEL, INDIANA 46032 20 BENNETT ROAD CHECK AMOUNT: $725.00
CARMEL IN 46032
CHECK NUMBER: 210604
CHECK DATE: 7/6/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350100 213592 315.00 BUILDING REPAIRS MA
1125 4350100 213595 410.00 BUILDING REPAIRS MA
213592
:fUN Q 7 2012 INVOICE
BY:
SOLD TO: SHIPPED TO:
ADDRESS 57 ADDRESS 20 Bennett Rd.
CITY, STATE, ZIP CITY, STATE, ZIP arme
G �L /I-- /6 0,32- IN 46U32
CUSTOMER'S ORDER SALESPERSON TERMS VIA F.O.B. ZAT E �9f
&L 73D 7Q Z- Z 0o
�d ►A- o �5 P�� 336'0 X53 1
2 I TI�A-�L YW/ 0,5; 2' !gyp 3c�
v 7'r� -iL
7-078/3 2 AyO
'30 00
£p 10�
T �Z�Iq 2 3a c�7
f, 45 T P'hV< Zo9YV3
U r DN 3 .ti£ w 7�.z5 -oc 9
goo-
"aipum PA
G`t3Z p F
a.LO llz5 N Dl G1 50
Mier
c�te� r
Approval _Date
8140
RECEIVED 213595
JUN 0 1 2012
INVOICE
SOLDTO:�
Ar a G SHIPPEXjers Backflow Ch eck Ser
ADDRESS TN ADDRESS ZO BZ1117 Rd.
CITY, STATE IP CITY, STATE, ZIP P4 46032
2f 470 y/' q' //L- 663 Z 575 -0782
CUSTOMER'S ORDER SALESPERSON TERMS VIA F.O.B. DATE
P
9bz01
00
P 93 PwF
G.LA Q 3 �01d0
Vne Deser j
Pure Approval Date Le 7/ 4 2
>:adanm 8140
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
5/24/12 213592 Back flow prevention inspections 30932 315.00
615/1 21359 Repair to West Park backflow 3 0932 410.0
Total 725.00
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
1 20
Clerk- Treasurer
Voucher No, Warrant No.
359344 Ayers Backflow Check Ser Allowed 20
20 Bennett Rd
Carmel, IN 46032
In Sum of
725.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 213592 4350100 315.00 1 hereby certify that the attached invoice(s), or
1125 213595 4350100 410.00 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
28 -Jun 2012
eo
Signature
725.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund