212597 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 365417 Page 1 of 1
ONE CIVIC SQUARE GLENROCK COMPANY
€ CHECK AMOUNT: $101.00
CARMEL, INDIANA 46032 � Po eox 95279
PALATINE IL 60095 CHECK NUMBER: 212597
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4236200 1171607 101 . 00 CEMENT
INVOICE
Remit to: INVOICE NUMBER
Glenrock Company /!f P.O. Box 95279 1171607
Palatine,IL 60095 Invoice Date Page
8/28/2012 05:49:47 1 of 1
630-530-9600
Company ORDER NUMBER
N J 1188734
Bill To: Ship To:
City of Carmel/Street Department City of Carmel/Street Department
3400 W. 131st Street WILL CALL
Carmel, IN 46074 IN
Customer ID: 15998
PO Number Terms Description Net Due Date Primary Salesrep Name
stock Net 30 09/27/12 Account House Indiana
Order Date Pick Ticket No Carrier Taker
8/20/2012 08:52:49 1190591 WILL CALL- CUSTOMER P/U RBRIDGFORD
Quantities Pricing
Item ID UOM Unit Extended
Item Description Price Price
Ordered Shipped Remaining Unit Size
2.00 2.00 0.00 3611260FU UNT 50.50 101.00
IMCO 1260 MG KRETE FINE BAG 50LB& 1 GAL 1
Total Lines:I SUB-TOTAL: 101.00
TAX. 0.00
AMOUNT DUE: 101.00
YOU CAN ALSO CHECK US OUT ONLINE AT:
www.GlenrockCompany.com
ORIGINAL
VOUCHER NO. WARRANT NO.
ALLOWED 20
Glenrock Company
IN SUM OF $
P. O. Box 95279
Palatine, IL 60095
$101.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I 1171607 I 42-362.001 $101.00 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
Friday,,,,Septe 1 ber 07, 2012
)0/
Street Commissioner
SiCe,L CcrtTitIeSSipnSr
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))
08/28/12 1171607 $101.00
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