215837 12/19/2012 CITY OF CARMEL, INDIANA VENDOR: 365285 Page 1 of 1
0 ONE CIVIC SQUARE H D SUPPLY UTILITIES LTD
CARMEL, INDIANA 46032 PO BOX 4851 CHECK AMOUNT: $2,491.00
4 ?` ORLANDO FL 32802 CHECK NUMBER: 215837
CHECK DATE: 12/1912012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350080 2159343-00 2, 491 . 00 STREET LIGHT REPAIRS
UTILITIES
HD Supply Utilities LTD. INVOICE
P.O. Box 4851
Orlando, FL 32802
Phone: 940-270-7220 UP:Cfz i < . I:. .:Q:..:.:.:. T ICE'
Fax: 866-580-8629 000000 :12/11/2012 2159343-00
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BILL TO: CITY OF CARMEL SHIP TO: CITY OF CARMEL
CARMEL STREET DEPT. 3400 W 131ST STREET
3400 W 131ST STREET CARMEL, IN 46074
CARMEL, IN 46074
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Last Page
VOUCHER NO. WARRANT NO.
ALLOWED 20
HD Supply Utilities LTD
IN SUM OF $
P. O. Box 4851
Orlando, FL 32802
$2,491.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 2159343-00 I 43-500.801 $2,491.00 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
P jF „F,rFday,',December"14, 2012
Street.Commissioner
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))
12/11/12 2159343-00 $2,491.00
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