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216858 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 361527 Page 1 of 1 ONE CIVIC SQUARE REGAL PRINTING CHECK AMOUNT: $521.80 CARMEL, INDIANA 46032 485 GRADLE DR CARMEL IN 46032 CHECK NUMBER: 216858 CHECK DATE: 1/29/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4230000 34327 521 . 80 OFFICIAL FORMS INVOICE 0 0 34327 01/2612013 0 0 485 Gradle Drive Sales Rep: House Acct. 1 a a Carmel,IN 46032 Customer#: 2287 [Ab-* 317.844.1723 Rrg Page : 1 of 1 arketing design print mail sig 317.844.3621 fax ns regal printing.net Tax Exempt:0031201550-020 BILL TO: SHIP TO: City of Carmel City of Carmel Building and Code Services Building and Code Services 1 Civic Square 1 Civic Square Carmel,IN 46032 Carmel, IN 46032 Attn: Ref/PO# y�, • • •� � lam.. •. .®C.x• ! Net 10 (317)571-2288 (317)571-2499 Pam Lux Dave 1,000 Forms-Commercial permit application 260.90 3 Part Carbonless 8.5000 x 11.0000 Printed 1/Side 1,000 Forms-Residential permit application 260.90 3 Part Carbonless 8.5000 x 11.0000 Printed 1/Side Will Call 521.80 0.000 0.00 0.00 Is 521.80 Thank You for your order! VOUCHER NO. WARRANT NO. ALLOWED 20 Regal Printing IN SUM OF $ 485 Gradle Drive Carmel, IN 46032 $521.80 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members Prior Year I hereby certify that the attached invoice(s), or 1192 42-300.00 bill(s) is (are)true and correct and that the 1192 34327 42-300.00 $521.80 materials or services itemized thereon for which charge is made were ordered and received except Monday, Janu ry 28 2013 Y 1 Directo 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)) 01/26/13 34327 Commercial/Residential Applications $521.80 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