214341 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 358552 Page 1 of 1
ONE CIVIC SQUARE INTELLIGENT CLEANING SYSTEMS INC CHECK AMOUNT $198.30
CARMEL, INDIANA 46032 17406 TILLER COURT SUITE 300/400
WESTFIELD IN 46074 CHECK NUMBER. 214341
CHECK DATE. 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4238900 17864 198 30 OTHER MAINT SUPPLIES
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Intelligent Cleaning Systems, Inc �S Invoice
17406 Tiller Ct. t Z�
Suite 30N400 Date Invoice#
Westfield, IN 46074 10/30/2012 17864
Bill To Ship To
City of Carmel City of Carmel
One Civic Square One Civic Square
Carmel, IN 46032 Carmel, IN 46032
Attention.Accounts Payable
P O Number Terms Rep Ship Via F O B Project
Jeff 1% 10 Net 30 WDF 10/30/2012 ICS Truck
Quantity Item Code Description U/M Price Each Amount
30 DPR 10 DoorPod Santa Barbara Sea Breeze Refill. Each 6.61 198.30
pQa
Nov 0 5 7012
By _ E
Total $198.30
Phone# Fax# E-mail
3178675424 3178675416 b fisher a intelligentcleaningsystems.com
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))
10/30/12 17864 $19830
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
Intelligent Cleaning Systems, Inc
IN SUM OF $
17406 Tiller Ct., Suite 300/400
Westfield, IN 46074
$19830
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO ACCT#/TITLE AMOUNT Board Members
1205 17864 42-38900 $19830 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
Monday, November 05, 2012
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund