214682 11/20/2012 >_� f CITY OF CARMEL, INDIANA VENDOR: 354857 Page 1 of 1
ONE CIVIC SQUARE HOOSIER PORTABLE RESTROOMS INC
to CARMEL, INDIANA 46032 2201 E 99TH ST CHECK AMOUNT: $230.00
L�o� INDIANAPOLIS IN 46280 CHECK NUMBER: 214682
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 6598 100 . 00 GENERAL PROGRAM SUPPL
1096 4239039 6662 130 . 00 GENERAL PROGRAM SUPPL
Hoosier Portable Restroorns, R-ECEIVIED Invoice
License #29-031/33/35 r--,---T
Date I !11voice#
2201 E. 99th Street NOV 12012 1 i
Indianapolis, IN 46280 Y. 10,4/'20 6598
FBY:
Bill To CLIstorner Phone Customer Fax
Carmel Parks Department 317-848-7275 317-573-5254
1235 Central Park Drive East
Carmel,IN 46032
Project P.O. No. 'I P-r ms
NIC003394 Due upon receipt,please.
Item Service Dates Quantity Rate Amount
Standard Unit(s)Serviced-SE Oct 27,2012 1 100.001 100.00
Purchase
Description Mfftt�QAU
p.0.# MC,11510 °N4 -- �JP F
N
G.L# � lQ-00 A 12
Budget
Line
Purchaser to
provalA Date!Ata
i r _
Thank you for your business. 'Total $100.00
Our Phone# Our Fax#
(317)844-6919 (317)844-6919
Hoosier Portable Restrooms, =-F _) Invoice
License #29-031/33/35 2201 E. 99th Street Date Invoice#
Indianapolis, W 46280
10/22/2012 6662
Bill To Customer Phone Customer Fax
Carmel Parks Department 317-848-7275 317-573-5254
1235 Central Park Drive East
Carmel,IN 46032
Project P.O. No. Terms
Tour De Carmel 2012 Due upon receipt.please.
Item Service Dates Quantity Rate Amount
September 14,2012
Standard Unit(s)Serviced-SE Mohawk"Trails Elem 1 65.00 65.00
Standard Unit(s)Serviced-SE Prairie Trace 1 65.00 65.00
Purchase r
Description
P.O.# M('.DOSa a P s F
G.L.# �Oq �O.y23�to3�l
Budget
Line D a #Purchas er rate
Approval Date-j �OL
It is a pleasure working with you!
Total
$130.00
Our Phone# Our Fax#
(317)844-6919 (317)844-6919
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
354857 Hoosier Portable Restrooms, Inc. Terms
2201 E. 99th Street
Indianapolis, iN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/4/12 6598 Sk8 Night Port-a-let $ 100.00
10/22/12 6662 Tour de Carmel Port-a-lets $_ 130.00
Total $ 230.00
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.
354857 Hoosier Portable Restrooms, Inc. Allowed 20
2201 E. 99th Street
Indianapolis, iN 46280
In Sum of$
$ 230.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-60 6598 4239039 $ 100.00 1 hereby certify that the attached invoice(s), or
1096-60 6662 4239039 $ 130.00 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
15-Nov 2012
Signature
$ 230.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund