217591 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 057000 Page 1 of 1
1 ONE CIVIC SQUARE CHARLIES RADIATOR SERVICE INC CHECK AMOUNT: $40.00
,o CARMEL, INDIANA 46032 740 EAST 106TH ST.
INDIANAPOLIS IN 46280 CHECK NUMBER: 217591
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 001 40 . 00 OTHER EXPENSES
R444fol Smpae
740 East 106th Streit
Indianapolis, Indiana 46280
844.9452
OI►TE YOUR OAOE11 NO.
sm vI• / V Trmus N E/T 30, DA YS
_ f V�A
M4NE 1�,./. MOOED cUkRANTEE
THIS RADIATOR
JOB N0, C, I WAS PLUGGED
CLEAN AND REPAIR .RADIATOR._
RECORE RADIATOR
ROC OUT RADIATOR
CLEAN AND REPAIR GAS.'TANK �
REMOVE AND.REPLACE ATER PUMP
RECORE HEATER _
COMPLETE NEW HEATER jM T--
REMOVE,':ANO�RVLACF- RAO[ATOR/
THERMOSTAT AND GASKET
PARTS AND MATERIALS is
COMPLETE NEW RADIATOR
REMOVE & REPLACE GAS TANK
ANTIFREEZE
REIdOVE AND REPAIR THERMOSTA
FEDERAL TA9
STATE TAX .
MATERIAL: TOTAL
TOTAL
% K . To
Po,
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
57000
CHARLIES RADIATOR SERVICE Purchase Order No.
740 EAST 106TH ST. Terms
INDIANAPOLIS, IN 46280 Due Date 2/20/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/20/2013 001 $40.00
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
L IL--2-113 -
Date Officer
VOUCHER # 126699 WARRANT # ALLOWED
57000 IN SUM OF $
CHARLIES RADIATOR SERVICE
740 EAST 106TH ST.
INDIANAPOLIS, IN 46280
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
001 01-7362-06 $40.00
I
Voucher Total $40.00
Cost distribution ledger classification if
claim paid under vehicle highway fund