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214615 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 00352917 Page 1 of 1 ONE CIVIC SQUARE DOMESTIC UNIFORM RENTAL CARMEL, INDIANA 46032 3401 COVINGTON ROAD CHECK AMOUNT: $57.35 KALAMAZOO MI 49001 CHECK NUMBER: 214615 CHECK DATE: 11/20/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4350900 1112126605 57 . 35 OTHER CONT SERVICES LINEN INVOICE 1 YOUR LOCAL DOMESTIC UNIFORM RENTAL IN 1 1 1 1 c b£� } - SVC TEL.# DOMESTIC LINEN- KALAMAZOOSOO-480-08/2 - TEL#OFFICE MAIN 3401 COVINGTON ROAD 269-388-2900 KALAMAZOO MI 49001 CARMEL_ CLAY COMMUNIC C 31 FIRST AVE NW 9 1 CARMEL IN 11 12 12 46032 MO DA YR. 2 C.O.D. WEEOKF RENTAL SERVICE ITEMS BILLING UNIT AMOUNT QUANT. PRICE PAYMENT DUE BY 12/12/12 LOS ANGELES,CA ORANGE COUNTY,CA RIVERSIDE,CA SAN DIEGO,CA VENTURA CA CHICAGO, IL 3 RED VY MAT 1225 2r5 ADDISON, IL GURNEE, IL FT.WAYNE,IN 5 RED VY MAT 3445 13-j5 INDIANAPOLIS,IN SOUTH BEND,IN BALTIMORE,MD b RED VY MAT 2535 1 3',70 HAGERSTOWN,MD DETROIT,MI FLINT,MI 10 -RED VY MAT 1325 325 GRAND RAPIDS,MI JACKSON,MI KALAMAZOO,MI S ,SCRAPER MAT 1 0 900) LANSING,MI SAGINAW,MI TROY,MI ENVIRONMENTAL FEE 1()()o LIVONIA,MI NEWARK/NEW YORK RALEIGH,NC CANTON,OH CINCINNATI,OH CLEVELAND,OH COLUMBUS,OH DAYTON,OH TOLEDO,OH YOUNGSTOWN,OH HARRISBURG,PA PHILADELPHIA,PA PITTSBURGH,PA VIRGINIA BEACH,VA " RICHMOND,VA MILWAUKEE,WI THIS DELIVERY IS MADE UNDER EXISTING RENTAL AGREEMENT RT. STOP ACCOUNT PAY THIS PLEASE PAY FROM NO. NO. NO AMOUNT $ THIS INVOICE.NO 308 260 8466 D S t 35 OTHER WILL BE ISSUED. ADJUSTMENT $ NET $ RECD BY VOUCHER NO. WARRANT NO. ALLOWED 20 Domestic Linen IN SUM OF $ 3401 Covington Road Kalamazoo, MI 49001 $57.35 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1115 I 1112126605 I 43-509.00 I $57.35 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 Wednesday, November 14, 2012 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 11/12/12 1112126605 $57.35 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