212287 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 359067 Page 1 of 1
ONE CIVIC SQUARE LINE-X OF INDY
CARMEL, INDIANA 46032 8448 MOLLER ROAD CHECK AMOUNT: $368.00
INDIANAPOLIS IN 46268
CHECK NUMBER: 212287
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 1458 368 . 00 REPAIR PARTS
Line-X of Indy Invoice
LlIt ::► 8448 Moller Rd
PROTECTIVE COATINGS Indianapolis, IN 46268 Date Invoice#
(317)228-0123 08/14/2012 1458
linexofindy @hotmail.com
http://www.linex-indy.com
Bill To
Carmael Fire Department
2 Civic Square
Carmel, IN 46032 USA
Amount Due Enclosed
$368.00
Please detach top portion and reium with your payment_
------------------------ --- ---- -- --- ----------------------------------
Date Product ' Description Quantity Amount
08/14/2012 Accessory Sales Pair of CIPA towing mirrors 1 368.00
SubTotal $368.00
Tax(7%) $0.00
Total $368.00
Thank you for your business!
prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n 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))
1458 $368.00
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Line-X
IN SUM OF $
8448 Moller Road
Indianapolis, IN 46268
$368.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 1458 I 42-370.00 I $368.00 I 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
AUG 272012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund