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215791 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 360025 Page 1 of 1 ONE CIVIC SQUARE UNIFIRST CORPORATION 0 CARMEL, INDIANA 46032 4201 INDUSTRIAL BLVD CHECK AMOUNT: $266.95 r� INDIANAPOLIS IN 46254 CHECK NUMBER: 215791 CHECK DATE: 12/18/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 0820727451 266 . 95 OTHER EXPENSES Un1F1rst Corporation PAGE 00 4201 INDUSTRIAL BLVD INDIANAPOLIS IM 46254 `= INVOICE DATE PAYMENT TERMS PURCHASE ORDER CONTRACT ' 082 0727451 12/12/12 CHARQE 45O172 7��.[)I °~ ,= D,?609 HAZEL DELL PARKWAY (IF, 609 HAZEL DELL PARKWAY SINDIANAPOLIS IN 46280 JNDIANAPOLIS IN 46280 IF YOU HAVE A QUESTION REGARDING THIS INVOICE,CALL: 317/293-5026 RTE# H4680 Cal 0�v- � MAT-3X5 U1ST GREAT I �Z 5 OD 5/09 2 . _ -_— MAT-4X6 U1ST GREAT I 5 19. 50 5/09 5 1 7� 2O 5/D9 8X18 WIPERS m ---- ----- a REPLACE-18X18 WIPERS _ . 5 2. 45 BAGGED 18X18 WIPERS _ _ 14. 40 _ 5/09 . REPLACE—BAGGED 18X18 W 19 9, 31 ' HANDLE/FRAME 24" �Z 5/09 -' � 24" DRY MOP 2 1. �B 12/O9 2 �� _ — _ - �~ TERRYCLOTHS—UNIFIRST _ 100 17. 00 3/10 47 - 8 6 4O REPLACE—TERR�CLOTHB—UN � � SOIL LOCKER �� _ 6/O9 - 8 COMPARTMENT LOCKER _ 2 6/09 � 0001 1 GARY LAFOLLETTE 7, 92 5/09 2A} / � LS SHIRT-65/35 6 ' - S. S. SHIRT-65/35 5 - JEAN COTTON RIGgS CH 1 � _ _ _ 0002 34 LARRY EIDSON 7. 81 6/12 —_-_ - - S. S. SHIRT-65/35 11 — '- JEAN—WRANGLER RELAX 11 . - 0003 24 MIKE TURNER 8. 98 1/11 _ . LS SHIRT-65/35 5 — S. S. SHIRT-65/3 5 6 JEAN COTTON RIgGS CA 11 ' COVERALL-65/35 2 _ � gOQ4 4 BLAINE MALLABER 8� 98 5/09 —' ' LS SHIRT-85/35 3- S. S. SHIRT-65/35 8 ' JEAN COTTON RIQG;S CA ' 11 � � COVERALL-65/35 2 0005 5 JEFF COOPER — 4� 84 5/09 ' i \ \ L JEAN--WRANGLER RELAX . 11 ` / 0006 6 DAVID TURNER 7. 92 ` /09 0 LS SHIRT-65/35 5 - ' S. S. SHIRT-65/35 6 � JEAN COTTON RIQgG CA 11 � /O9 ODO8 8 DAVE DYE 7. 88 — ' ' , JEAN WRANGLER RELAX 13 _ o� SERVICE HEREIN RENDERED mPURSUANT TO A WRITTEN CONTRACT CUSTOMER COPY ! '-` WITH UNIFIRST CORPORATION OR UNIFIRST HOLDINGS, INC. INVOICE NUMBER 082 0727451 REMIT T0:UniFirst Corporation INVOICE DATE 12/12/12 4201 INDUSTRIAL BLVD ` /- CUGTOMEF# (3|LLTO) 8O9566 INDIANAPOLIS IN 46254 A/R NUMBER RTE# H4680 m CUSTOMER CITY OF CARMEL UTILITI �N� PAYMENT � |�N0UU0iU||KU@UBU8HU|00|0U0||�0U0��0|NUNUUU!U�!NU� �� 0820727451- L p� � ' _ U�U�� Detach �� K�� ^�� U�� ~ Please _- ~-~_~' ' and Return' , . . ... , Payment. . ..~. .. .� UniFirst Corporation PAGE 002 4201 INDUSTRIAL BLVD INDIANAPOLIS IN 46254 .� INVOICE DATE PAYMENT TERMS PURCHASE ORDER CONTRACT � O82 0727451 122/12/12 CHARGE 450172 809S66 809566 609 HAZEL DELL PARKWAY {�`609 HAZEL DELL PARKWAY INDIANAPOLIS IN 46280 NDIANAPOLIS IN 46280 `= |F YOU HAVE A0usSTIOw REGARDING THIS INVOICE,CALL: 317/293-5026 RTE# H4680 ^ 9 LAB COAT POLY/COTTON _ _-__--� ' OOO9 9 JOE FAUCETT 1� O6 5/O9 COVERALL-65/35 2 c 0010 10 LARRY SCHIMMEL 2170 JEAN COTTON RIgGS CA 6 �� 0011 11 BART CHAFIN ----- ' 7. 81 ------� /09 S S SHIRT-65/35 1l � . � -__ - � JEAN-WRANGLER RELAX 11 8 `----' - - ' -----'' �� OD12 12 DENNIS RUSS 5. 9O 5/09 �� ---'__' -_-_-- � JEAN-WRANGLER RELAX 11 a co COVERALL-65/35�� 2 0013 13 LONNIE PAJTON _ _ 7. 81 _ _.5/09 0 . S. S' SHIRT-65/35 11 JEAN-WRANgLER RELAX ' -- 11 �� 4. 95 ' - OD14 14 ERIC ROBINSON - '-- - -/O9 ` ---~ ` '---'-- JEAN COTTON RIQgS CA . 11 0015 15 KEVIN BUHMANN 7. 92 5/O9 S. S. S |IRT-65/ � 5' 1 1 `---- ' ' - -__'- JEAN COTTON RIGQS CA 1 � ---- C016 16 RALPH GRUWELL 7. 81 5/O9 LS SHIRT-6i/35 - -- 5 ' ' - . S, S. SHIRT-65/35 � 6 JEAN-WRANGLER RELAX 11 _ - - --- OO17 17 PETE 8RENNAN _ _ 7. 92 5/09 S. S. � . � SHIRT-65/35 . - . JEAN COTTON RIQQS CA 11 0018 18 RO88IE KINKEAD ' - 6� 01 JEAN COTTON RIQgS CA COVERALL-65/35 ' -` :Z '^ OO19 19 TARA RUBBISH ' 5� 58- '/09 - ' ' PANT SCRUB 6S/35, 1 P lI LAB COAT-POLY/COTTON 4 z'1�SS SCRUB 65/35 l 'PKT ` �� - ^ ` 001=10 20 BRAD OLIVER 6. 01 5/09 JEAN COTTON R7QggCA ` 11 . PREPARATION CHARGE � I '1 5g ' _ ` ` COVERALL--65/35 2 � �` ' SERVICE HEREIN RENDERED m PURSUANT TO A WRITTEN CONTRACT CUSTOMER COPY WITH uwIFmnT CORPORATION nnuw/FInar HOLDINGS,INC. INVOICE NUMBER 082 0727451 RsmrrnlUniFirst Corporation � ^ INVOICE DATE 12/12/12 4201 INDUSTRIAL BLVD /44 } CUSTOMER# (8|LLTO) 80?566 INDIANAPOLIS IN 46254 A/R NUMBER RTE# H4680 * CUSTOMER CITY OF CARMEL UTILITI ||0UU|U0N�|N|�U0UN8U||WN UU|U�U0|UN|QUU|UNU8Q||N�{ PAYMENT AMOUNT $ "mm'/u*mmomxmxnumm° .o."°om."w/wumxm"mm//�m 0820727451- Please D`~~~~-. . ~~, .,~ Return With. . .~y. . ..~. .^ _��-- UniFirst Corporation Pxas 003 4201 INDUSTRIAL BLVD INDIANAPOLIS IN 46254 INVOICE DATE PAYMENT TERMS PURCHASE ORDER CONTRACT O82 0727451 12/12/12 CHARGE 45D172 809566 809S66 FITY OF CARMEL UTILITIES OF CARMEL UTILITIES OV609 HAZEL DELL PARKWAY N!60? HAZEL. DELL PARKWAY INDIANAPOLIS IN 46280 quiNDIANAPOLIS IN 46260 |p YOU HAVE A QUESTION REGARDING THIS INVOICE,CALL: 317/293-5026 RTE# H4680 � /JD21 �l1 DALE RILEY _ 7. 92 _ 5/09 . ' S. SHIRT-65/35 1l JEAN COTTON R%��S CA 1 1 . c 0022 26 AARON HOOVER _^ 4. 95 JEAN COTTON RIGGG .CA 11 0023 27 JASON STEWART . 4� 95 6/12 _ JEAN COTTON RIQGS C�� 11 L ---- ---_--- � ^ F0024 31 CALVIN COOPER 4. 84 612 8�� ----- ' / ----- - ' �� JEAN-WRANgLER RELAX 11_ - 0026 29 CURT MANIFOLD , S. 90 8/12 � JEAN-WRANGLER RELAX 11 COVERALL-65/35 _ .__ 2 ` � �OD� 26 RANDY ��I�ILL 5 — 6/12 ' ° JEAN COTTON RIGGS CA 11 COVERALL-65/3.5 ` -- -- 1 - -- ' �----- 0028 33 GREG EPP _ _ � 4. 84 _6/12 _ JEAN-WRANGLER RELAX 11 0029 32 MICAH BECK _ 7 92 _ 6/12 _ SG G SHIRT-65/35 11 . � - '-~ - --- ' ' JEAN COTTON RIQGS CA 11 DEFE CHARQE 1O� OO - INVOICE SUB-TOTAL 266. 95 - - - TOTAL SERVICE CHANGES AMOUNT DUE THIS IS YOUR ONLY %NVCE- NET 30 DAYS. PLEASE SIGN SOIL PICK UP COUNT H OT NO ---�-- ' --�--- � ---7--� ----�- ' ! } SERVICE HEREIN RENDERED/o PURSUANT TO A WRITTEN CONTRACT CUSTOMER COPY WITH mwFInar CORPORATION onuw/p/nurHOLDINGS, INC. INVOICE NUMBER 082 0727451 REMIT T0UniFirst Corporation \�\ INVOICE DATE 12/1.2/12 4201 INDUSTRIAL BLVD >rr CU8T0MEmo (BILL TO) 8O9566 INDIANAPOLIS IN 46254 A/R NUMBER RTE# H4880 .^ CUSTOMER CITY OF CARMEL UTILITI l|N�UD00||�U0i|0HH0U|�0|8U8U|8NUN|H&|QU0U&||00 \0U\ ||NNU0HN||N|NU8UU�U|000U0||U0D8|�N|NUMUUU0�|NN �NNPAYMENT � '~~^^~~~^~^~^~~~~~'^^~`'~~^~'^~'~^^'~^'~^^~^' ~ O82O727451- ' 8�U�� Detach �� K�� ^�� U�� ~ Please ~~,~..~.~. . and Return With Payment.. =, Opt UniFirst Corporation PAGE 004 4201 INDUSTRIAL BLVD INDIANAPOLIS IN 46254 INVOICE DATE PAYMENTTERMS PURCHASE ORDER CONTRACT ' 082 0727451 12/12/12 CHARGE 450172 809566 (D 809S66 0�609 HA' EL DELL PARKWAY T�i'609 HAZEL DELL PARKWAY NDIANA OLIS IN 46280 �.INDIANAPOLIS IN 46260 (4) 101 `= i� IF YOU HAVE A QUESTION REGARDING THIS INVOICE,CALL: 317/293-6026 RTE# H4680 LIU @ --'--- -------` � ~ � �r -__- -_- -- . ' , \ ' �� SERVICE HEREIN RENDERED IS PURSUANT TO A WRITTEN CONTR ACT CUSTOMER COPY WITH UNIFIRST CORPORATION OR UNIFIRST HOLDINGS,INC. VOUCHER # 126352 WARRANT # ALLOWED 360025 IN SUM OF $ UNIFIRST CORPORATION 4201 INDUSTRIAL BLVD INDIANAPOLIS, IN 46254 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 082 0727451 01-7362-05 $266.95 Voucher Total $266.95 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee , 360025 UNIFIRST CORPORATION Purchase Order No. 4201 INDUSTRIAL BLVD Terms INDIANAPOLIS, IN 46254 Due Date 12/13/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/13/201: 082 0727451 $266.95 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 Date Officer