215410 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 357097 Page 1 of 1
ONE CIVIC SQUARE SERVICE FIRST CLEANING, INC CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 PAYMENT PROCESSING CENTER
10632 GRAND RIVIERE DRIVE CHECK NUMBER: 215410
TAMPA FL 33647
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4350600 153142 200 . 00 CLEANING SERVICES
Service First Cleaning Invoice
Payment Processing Center
Date Invoice#
10632 Grand Riviere Dr.
Tampa, FL 33647 12/1/2012 153142
Bill To
City of Carmel Treasurer's Dept
One Civic Square
Carmel,IN 46032
P.O. No. Terms Project
Net 30
Quantity Description Rate Amount
I FOR THE MONTH OF DECEMBER 200.00 200.00
Thank you for your business.
Total $200.00
Prescribed by State Board of Accounts ACCOUNTS PAYABLE� VOUCHER City Form No.201(Rev.1995)
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 ill(s))
Total
I 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.
p I ALLOWED 20
c 1 f
IN SUM OF $
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ON ACCOUNT OF APPROPRIATION FOR
C h t
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# r I hereby certify that the attached invoice(s), or
-
7- 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