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Home My WebLink About215107 12/04/2012 *f CITY OF CARMEL, INDIANA VENDOR: 355635 Page 1 of 1 ONE CIVIC SQUARE MIKE'S EXPRESS CAR WASH CARMEL, INDIANA 46032 10251 HAGUE ROAD CHECK AMOUNT: $300.80 INDIANAPOLIS IN 46256 <.o � CHECK NUMBER: 215107 CHECK DATE: 12/4/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351100 25516 5468 300 . 80 TICKETS s Mike's Carwash,lnc. INVOICE t 10251 N.Hague Road Indianapolis, IN 46256 -- INVOICE DATE Phone: (317) 572-9250 Fax: (317) 572-9251 11/15/2012 ..:_...- INVOICE NUMBER Email Address:mcw @mail.fwi.com Web Site: http:\\www.mikescarwash.com 005468 CUSTOMER NUMBER City of Carmel Police Dept. CARPD01 Teresa Anderson TERMS 3 Civic Square Carmel,IN 46032 Net 30 Description QTY UNIT PRICE AMOUNT .Express Singles 47.00 8.00 376.00 Discount 1.00 -75.20 -75.20 Make Checks Payable to: Mike's Car Wash Attn: Accounts Receivable 10251 N. Haque Road 1of 1 Indianapolis, IN 46256 TotalDue 300.80 INDIANA RETAIL TAX EXEMPT PAGE City o Carmel CERTIFICATE NO.003120155 002 0 1� PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 25516 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION W1212 Miko's Car Wash Carmal Police D paAment VENDOR SHIP 3 Civics Square TO 10251 N. Hague Road Carmel, IN AID Indianapolis, IN 4$258 (317)5711 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account -6i l.00 47 Each car Dash tickets $6.40 $300.50 Sub Total: $300.50 6 I t rh yrp ` r Y-3 i y o �) Send Invoice To: r Carmel pallid Department �p Attn. Teresa Andol° on 3 Civic Square Carmel, IN PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Sept, ' PAYMENT $3W.80 y A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT TdHEREIIS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY O .✓lJr < ..... •PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ila g of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 253 1 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.__---_�WARRANT NO.______. ALLOWED 20 IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR - a Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# 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.--- - - ---- --------=----.... 20 .........------..............................--.........-.........................._.._............................_.....-._.._........-.. --..... Signature Title 'Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Mike's Car Wash IN SUM OF $ 10251 N. Hague Road Indianapolis, IN 46258 $300.80 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25516 I 5468 I 43-511.00 I $300.80 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 28, 2012 Chief of Police 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)) 11/15/12 5468 car wash tickets $300.80 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