213409 10/09/2012 a CITY OF CARMEL, INDIANA VENDOR: 353562 Page 1 of 1
ONE CIVIC SQUARE CINTAS FIRST AID&SAFETY CHECK AMOUNT: $67.91
CARMEL, INDIANA 46032 PO BOX 633842
CINCINNATI OH 45263-3842 CHECK NUMBER: 213409
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350900 5000154552 67 . 91 OTHER CONT SERVICES
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CUSTOMER COPY TERMS NET 10 CFAS-INV
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CUSTOMER COPY TERMS NET 10 CFAS-1W
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))
09/27/12 5000154552 First aid Service $67.91
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.
ALLOWED 20
Cintas Corporation ,��'� ��
IN SUM OF $
P.O. Box 633842
Cincinnati, OH 45263-3842
$67.91
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 5000154552 I 43-509.00 I $67.91 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
Thursday, September 27, 2012
Director, Brooks[TO Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund