214050 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 353477 Page 1 of 1
ONE CIVIC SQUARE PROFESSIONAL GARAGE DOOR SYST E��
CARMEL, INDIANA 46032 6030 GATEWAY DRIVE MILK AMOUNT: $160.00
_. PLAINFIELD IN 46168 CHECK NUMBER: 214050
CHECK DATE: 10123/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 2578GS 160 . 00 BUILDING REPAIRS & MA
&"'OM Professional Garage Door Systems, Inc. INVOICE
GARAGE DOOR 6030 Gateway Drive
Plainfield, IN 46168
Invoice Number: 25786s
Phone: (317) 839-3050 Invoice Date: 10/9/12
Fax: (317) 838-3533 Customer ID: CITYCA
Bill Ship
To: CITY OF CARMEL To: City Of Carmel
WASTEWATER UTILITIES 3400 W 131ST ST
3450 W. 131st ST Westfield, IN 46074
Carmel, IN 46032
Amount Due: $160.00
PO Number REMITTANCE AMOUNT
Due Date: 1118112
Work Order No 323270
Terms: Net 30 Department 15
Trip Date 10/09/2012 Trip No 27191
Type Quantity Item/Description Unit Price Total Price
Part 1 SPRAY LUBE Sanitary 14.00 14.00
Work GATE-Reset&Adjusted Loop Detectors,Tightened
Work Chain&Greased
Notes Lift Charge: 0.00
Material: 14.00
Energy Surcharge: 5.00
Tax: 0.00
Labor: 95.00
Trip Charge: 46.00
Discount:
Total: 160.00
Grand Total
Amount Subject to Amount Exempt Lift Charge: 0.00
Sales Tax from Sales Tax Material: 14.00
Energy Surcharge: 5.00
$19.00 $141.00 0
Tax: .00
Labor: 95.00
Payments Trip Charge: 46.00
Payment Date Type CC/Check# Amount Discount:
Total: 160.00
Amount Paid:
Amount Due: $160.00
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))
10/09/12 25786s $160.00
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
Professional Garage Door Systems, Inc.
/ I- IN SUM OF $
t 1 030
Plainfield, IN 46168 l
$160.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 1 25786s 1 43-501.001 $160.00 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
i Thursday, Octo'ber 18, 2012
= i .
Street Commissioner
(�nmmiccinn�-
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund