213385 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 027060 Page 1 of 1
Q � ONE CIVIC SQUARE BOLDEN'S CLEANING&RESTORATION CHECK AMOUNT: $1,819.80
CARMEL, INDIANA 46032 112 PARK 32 WEST DRIVE
NOBLESVILLE IN 46062 CHECK NUMBER: 213385
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350100 77730 922 . 80 BUILDING REPAIRS & MA
1120 4350100 78122 897 . 00 BUILDING REPAIRS & MA
Boldens Cleaning& Restoration Service Slip / Invoice
Park West Drive 1 INVOICE:W 77730
Noblesville, IN 46062 DATE: 09/13/12
317-773-7683 ORDER: 77730
Bill-To: [126108) Work [126108] 317-371-3140
CARMEL FIRE STATION#42 Location: CARMEL FIRE STATION#42
MR. SCOTT OSBORNE MR. SCOTT OSBORNE
3610 WEST 106TH STREET 3610 WEST 106TH STREET
CARMEL, IN 46032-9607 CARMEL, IN 46032-9607
09/13/12 08:30 AM �
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NET 30 09/13/12
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396 CTV T.V.ROOM $0.1500 $59.40
1393 CARPET DORM AREA $0.1500 $208.95
576 CTV T.V.ROOM $0.1500 $86.40 i
285 COF SHIFT OFFICE $0.1500 $42.75
100 COF CAPTAIN OFFICE $0.1500 $15.00
132 CBA BATHROOM-WOMENS AND SHOWER $0.1500 $19.80
270 CBA MENS BATHROOM $0.1500 $40.50
9 FRE RECLINERS IN TV ROOM $50.0000 $450.00
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S/A NEED TO SEND TECH AFTER ESTIMATION FOR TEST CLEAN ON TILE/GROUT..ESTIMATE CARPET& SUBTOTAL $922.80
ITILE...CONFIRMED APPT WITH SCOTT. TAX $0.00
TOTAL $922.80
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AMT.PAID $0.001
BALANCE $922.801
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Charges outstanding over 30 days from the date of service are subject to a 1%%FINANCE I hereby acknowledge the satisfactory completion of all services rendered,and agree to pay the
CHARGE PER MONTH or annual percentage rate of 18%.Customer agrees to pay accrued cost of services as specified above.
expenses in the event of collection.
-- - X /�
CUSTOMER SIGNATURE
PLEASE PAY FROM THIS INVOICE
Boldens Cleaning & Restoration Service Slip / Invoice
112 Park 32 West Drive INVOICE: 781.22
Noblesville, IN 46062 DATE: 09/19/12
317-773-7683 ORDER: 78122
........................... ..._. ......... __................ ...... .. .. ....._?
Bill-To: [126108] We lion: [126108] 317-371-3140
CARMEL FIRE STATION#42 CARMEL FIRE STATION#42
MR. SCOTT OSBORNE MR. SCOTT OSBORNE
3610 WEST 106TH STREET 3610 WEST 106TH STREET
CARMEL, IN 46032-9607 CARMEL, IN 46032-9607
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09/19/12 01:00 PM 2NC
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646 TILE KITCHEN-STRIP&CLEAN $0.4000 $258.40
646 TILE KITCHEN-SEAL $0.2000 $129.20
64 TILE BATH#1 MAIN-STRIP&CLEAN $0.4000 $25.60
64 TILE BATH#1 MAIN-SEAL $0.2000 $12.80
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I 64 TILE BATH#2 MAIN-STRIP&CLEAN $0.4000 $25.60
64 TILE BATH#2 MAIN-SEAL $0.2000 $12.80
180 TILE FOYER-STRIP&CLEAN $0.4000 $72.00
180 TILE FOYER-SEAL $0.2000 $36.00
120 TILE HALL MAIN-STRIP&CLEAN $0.4000 $48.00
120 TILE HALL MAIN-SEAL $0.2000 $24.00
172 TILE MENS LOCKER ROOM-UP-TOILET AREA CLEAN $0.4000 $68.80
f 172 TILE MENS LOCKER ROOM-UP-TOILET AREA SEAL $0.2000 $34.40
96 TILE MENS LOCKER ROOM-UP-SHOWER CLEAN $0.4000 $38.40
j 96 TILE MENS LOCKER ROOM-UP-SHOWER SEAL $0.2000 $19.20
90 TILE WOMENS LOCKER ROOM-TOILET AREA CLEAN $0.4000 $36.00
90 TILE WOMENS LOCKER ROOM-TOILET AREA SEAL $0.2000 $18.00
63 TILE WOMENS LOCKER ROOM SHOWER CLEAN $0.4000 $25.20
63 TILE WOMENS LOCKER ROOM SHOWER SEAL $0.2000 $12.60
,STRIP WAX THEN CLEAN&SEAL AS NORMAL...MEASURE&ADD TILE IN LOCKER ROOMS UPSTIARS YOU CLEANED SUBTOTAL $897.00
ON 09/13... TAX $0.00
TOTAL $897.00
E AMT.PAID $0.00!
if BALANCE $897.00
I
Charges outstanding over 30 days from the date of service are subject to a 1%%FINANCE I hereby acknowledge the satisfactory completion of all services rendered,and agree to pay the
CHARGE PER MONTH or annual percentage rate of 18%.Customer agrees to pay accrued cost of services as specified above.
expenses in the event of collection.
CUSTOMER SIGNATURE
PLEASE PAY FROM THIS INVOICE
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))
78122 $897.00
77730 $922.80
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
Bolden's Cleaning and Restoration
IN SUM OF $
112 Park 32 West Drive
Noblesville, IN 46062
$1,819.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 78122 43-501.00 $897.00 1 hereby certify that the attached invoice(s), or
1120 77730 43-501.00 $92280 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
OCT — ® �
9
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund