211409 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 355371 Page 1 of 1
ONE CIVIC SQUARE OTT EQUIPMENT SERVICE INC
CARMEL, INDIANA 46032 517 HERRIMAN CT CHECK AMOUNT: $167.15
�'+ ? NOBLESVILLE IN 46060
«o„� CHECK NUMBER: 211409
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 25273 167 . 15 REPAIR PARTS
&it517 Herriman Ct. Invoice
Noblesville, IN 46060
EOUIPMEW 317-773-8941 DATE INVOICE#
SERVICE INC.
7/9/2012 25273
BILL TO SHIP TO
Carmel Street Department Attn: Jeff Stewart
3400 W 131st Street 733-2001
Westfield,IN 46074
Job No. P.O.NO. TERMS REP
S03576 Due on receipt MES
QTY ITEM DESCRIPTION RATE AMOUNT
1 FD70-22ZN Chain Adj 38.40 38.40T
1 Truck Charge Truck Charge 35.00 35.00
1.25 Sery- Matt Service Labor-Matt 75.00 93.75
Bay#I West: R70Q-replaced u-bolt chain adjuster
and adjusted chain tension.
Sales Tax 0.00 0.00
Total $167.15
A 1.5% Service Charge will be assessed on amounts over 30 days past due.
We will accept credit card payments (MCNisa); however, all credit card
charges in excess of$1,500.00 will be subject to a 3% convience charge.
VOUCHER NO. WARRANT NO.
ALLOW ED 20
Ott Equipment Services
IN SUM OF $
517 Herriman Court
Noblesville, IN 46060
$167.15
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 25273 I 42-370.001 $167.15 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
!I n
fhursday�July 26 2012
I V
SSte.etgm rn issigrrer
Title
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))
07/09/12 25273 $167.15
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