210369 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 354380 Page 1 of 1
ONE CIVIC SQUARE GILLE COMPANY
CARMEL, INDIANA 46032 1146 SOUTH WEST ST CHECK AMOUNT: $326.29
INDIANAPOLIS IN 46225 CHECK NUMBER: 210369
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 G221720002 326.29 REPAIR PARTS
11 46 S. West Street INVOIC E DATE
Indianapolis, IN 46225
Phone: (317) 638-0441
Cille& COMPANY, INC. (888) 74-GILLE or (888) 744-4553 INVOICE NO. PAGE
CUSTOMER NO. BRANCH
REMIT TO: 1146S.West St., Indianapolis, IN 46225 100135 (3-K
TO TO
11 46074
Invoices unpaid 31 days after invoice date are subject to 1-1/2% per month service charge. Equivalent interest rate per annum is 18%. Invoices unpaid after 61 days
will also be subject to collection, and fees charged will be responsibility of the customer.
CUSTOMER P.O. R/S ORDER NO.
QUANTITY PART NO. PRICEtPER EXTENSION
FREIGHT TAXABLE SUB TOTAL TAX STATUS/STATE SALES TAX PLEASE PAY
1.
Any warranties on the product sold hereby are those made by the manufacturer. The seller hereby expressly disclaims
all warranties, either express or Implied, Including any implied warranty of merchantability or fitness to, a particular
purpose, and the seller neither assumes nor authorizes any other person to assume for it any liability in connection with
the sale of said products. Any limitation contained herelnepqyq�pjyfer biW d b I
CUSTOM
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))
06/20/12 G221720002 $326.29
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. WA NO.
ALLOWED 20
Gille Company, Inc.
IN SUM OF
1146 S. West Street
Indianapolis, IN 46225
$326.29
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member
2201 I 6221720002 I 42- 370.001 $326.29 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
/1 �Thursd�y June 28, 2012
Street Commi signer
�f�'P r�!'1IT'1 mic5`,irncr
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund