217997 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 00351240 Page 1 of 1
` ONE CIVIC SQUARE CHEM DRY BY KEVIN JONES
CARMEL, INDIANA 46032 1601 COUNTRY CLUB ROAD CHECK AMOUNT: $2,667.65
INDIANAPOLIS IN 46234 CHECK NUMBER: 217997
CHECK DATE: 3/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 25665 58607 2, 667 . 65 WATER DAMAGE REPAIRS
Invoice
58607
he Date: 2/22/2013
Appt. Time: 10:30 AM to 12:00 PM
1;?rier.�tsarer.�-•lealtl�iec.`°`
Actual Time: 10:30 AM to 12:00 PM
Cl emDry by Kevin .Jones Crew: Kevin
1601 Country Club Rd,Indianapolis,IN 46234 Sales Rep: Kevin
Phone:317-273-9814;FAX:317-273-9815 Source: Repeat
e co
Carmel Police Department Carmel Police Department
3 Civic Square 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
4141�
Home:317-571-2548 Site Contact Phone: 317-571-2548
Contact: 317-571-2548
W:Emergency Water Damages 1 $2,667.65 $2,667.65
Comments: Po#: Subtotal. $2,667.65
Tax:
Total: $2,667.65
Balance: $2,667.65
Terms: Upon Receipt
1of1
INDIANA RETAIL TAX EXEMPT PAGE
City o Carmel CERTIFICATE NO.003120155 002 0 Jl PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
31512013
CliomDry Camel Police Department
VENDOR SHIP 3 CIVIC squam
TO
4601 Country Club Road Camol, IN 46
Indianapolis, IN 4234 (397)6671-25139
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS - FREIGHT
Account QUANTITY �p��U}NI�TpOF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43 d.00
9 Each water damage repairs $2,667.65 $2,667.65
Sub Total: $2,667.65
' X
,
kz
Send Invoice To:
Attu: Teresa Arlti @mom
3 Civic Squat
Camel, IN 46t}32•• PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. r ;� PAYMENT $2,667.65
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O-
'`.. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFYfHATTHERE IS AN UNOBLIGATED BALANCE IN
THIS APPROP,R�ATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. RO
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �t
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
2 6:3 '§ CLERK-TREASURER
DOCUMENT CONTROL NO. A. •� COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
t:
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoices), 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
20
.....................................................................................................................................................................................
Signature
---..._..............__... .........._............._...................._._......_...._......._.._......_............_......
Title
I
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
ChemDry
IN SUM OF $
1601 Country Club Road
Indianapolis, IN 46234
$2,667.65
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25665 I 58607 I 43-501.00 I $2,667.65 1 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
Wednesday, March 06, 2013
Chief of Police
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))
02/22/13 58607 water damage repairs $2,667.65
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