210575 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 360025 Page 1 of 1
ONE CIVIC SQUARE UNIFIRST CORPORATION CHECK AMOUNT: $1,546.66
CARMEL, INDIANA 46032 4201 INDUSTRIAL BLVD
INDIANAPOLIS IN 46254
CHECK NUMBER: 210575
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 070212 1,546.66 CONT SVS -OTHER
SEWER
INVOICE AMOUNT ACCOUNT
681877 221.73 7362.05
638472 201.64
686627 403.79
total I 827.16
680309 197.23 7362.06
685026 253.63
688190 268.64
total 719.5
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f 4201 INDUSTRIAL BLVD INDIANAPOLIS IN 46254
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I CUSTOMER# (BILL TO) 809566 INDIANAPOLIS IN 46254
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4201 INDUSTRIAL BLVD INDIANAPOLIS IN 46254
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082 0683472 6/06/12 CHARGE 450172
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I WITH UNIFIRST CORPORATION OR UNIFIRST HOLDINGS, INC.
INVOICE NUMBER 082 0683472 REMIT TO: UniFirst Corporation
INVOICE DATE 6/06/12 4201 INDUSTRIAL BLVD
oUSTOmsF# (BILL TO) SO'? 566 INDIANAPOLIS IN 46254
V A/R NUMBER RTE# H4680
m CUSTOMER CITY OF CARMJ�L UTILITI
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PAYMENT AMOUNT
0820683472/
Please Detach and Retur^., With Pa������nf
UniFirst Corporation p4os 003
4201 INDUSTRIAL BLVD INDIANAPOLIS IN 46254
|wv0CE DATE PAYMENT TERMS PURCHASE ORDER CONTRACT
O82 0683472 6/{}6/12 CHARGE 450172
909566 E309S66
ITY OF CARMEL UTILITIES9 NitITY OF CARMEL UTILi"riEsg
4 W609 HAZEL DELL PARKWAY R HAZEL DELL PARKWAY
'q�INDIANAPOLIS IN 46280 WNDIANAPOLIS IN 46280
|p YOU HAVE A�� 5 17/293-5 026 RTE# H4680
3.41
DEFE CHARGE 1O� OO
INVOICE SUB-TOTAL 201.64_
TOTAL SERVICE CHANGES
}'k
AMOUNT DUE
THIS IS YOUR ONLY INVCE- NET
30 DAYS. P LEASE
OIL !rCK UP C[ SH OT NO
m=
aenvICs xsnEIm newosnso IS PURSUANT roAWRITTEN unwTnAor CUSTOMER COPY
WITH uw/FInoT CORPORAT onuw/FInar HOLDINGS, INC.
VOUCHER 125203 WARRANT ALLOWED
360025 IN SUM OF
UNIFIRST CORPORATION
4201 INDUSTRIAL BLVD
INDIANAPOLIS, IN 46254
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
070212 01- 7362 -05 $827.16
070212 01- 7362 -06 $719.50
Voucher Total $1,546.66
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
360025
UNIFIRST CORPORATION Purchase Order No.
4201 INDUSTRIAL BLVD Terms
INDIANAPOLIS, IN 46254 Due Date 6/28/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/28/2012 070212 $1,546.66
I 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
Date Officer