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213356 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 362886 Page 1 of 1 ONE CIVIC SQUARE ALLIED CLEANING SOLUTIONS 11600 COMMONWEALTH DRIVE CHECK AMOUNT: $2,459.80 CARMEL, INDIANA 46032 L _off`o LOUISVILLE KY 40299 CHECK NUMBER: 213356 CHECK DATE: 10/9/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4238900 12088400 2, 459 . 80 OTHER MAINT SUPPLIES ******************* REMIT AND MAKE CHECK PAYABLE TO ******************* * CUSTOMER NUMBER * ALLIED CLEANING SOLUTIONS * INVOICE NUMBER * 500940 * 11600 COMMONWEALTH DRIVE * 120884-00 ******************* ******************* LOUISVILLE , KY 40299 SOLD TO: CARMEL CLAY PARKS & REC SHIP TO: MONON CENTER 1411 E 116TH STREET 1235 CENTRAL PARK DRIVE CARMEL, IN 46032 PH#317/573-4026 CARMEL, IN 46032 317/573-4023 SERRA GARSKE SALESMAN DATE CUSTOMER NUMBER NAME INVOICED ORDER NUMBER TERMS SHIP VIA F.O.B. 50 BROADSTREET 09/26/12 31246 NET 30 DAYS OUR TRUCK CUSTOMER SPECIAL BILLING INSTRUCTIONS: FAX QUANTITY QUANTITY QUANTITY ITEM NUMBER/ QUANTITY UNIT EXTENDED T ORDERED SHIPPED BACKORDERED UM DESCRIPTION BILLED UM PRICE PRICE X --------------------------------------------------------- ----------- 10 9 1 ! EA PG-LOWTIDE 9 EA 109.00 961.00 N 1 24201 2X TIDE DETER 2.5 GALLON 10 10 0 EA PG-OPCLOR5 10 EA 46.65 466.50 N 2 41676 PROLINE CLOROX BLEACH 5G 10 10 0 EA PG-OPDOWN5 10 EA 100.98 1009.80 N 3 48142 PROLINE DOWNY 5 GAL ------------- III N N V V 000 III CCCC EEEEE SUB-TOTAL 2457.30 I NN N V V O O I C E I N N N V V O O I C EEE FUEL SURCHARGE 2.50 I N NN V V O O I C E III N N V 000 III CCCC EEEEE TOTAL 2459.80 Purchase ��y� , Description �'��^'"' """ P.O.# F G.L.# coq(Q"21' 4ZJ99t�o Budget �.... �+ 7 � Line Descr Purchaser Date S E P 2_; 7 2012 Approval Date BY: * * * END OF INVOICE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 362886 Allied Cleaning Solutions Terms 11600 Commonwealth Drive Louisville, KY 40299 Invoice ;;Number nvoice Description Date (or note attached invoice(s)or bill(s)) PO# Amount 9126112 088400 Laundry supplies 31246 $ 2,459.80 Totald $ 2,459.80 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 20_ Clerk-Treasurer Voucher No. Warrant No. 362886 Allied Cleaning Solutions Allowed 20 11600 Commonwealth Drive Louisville, KY 40299 In Sum of$ $ 2,459.80 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-21 12088400 4238900 $ 2,459.80 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 4-Oct 2012 Signature $ 2,459.80 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund