218767 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 362455 Page 1 of 1
ONE CIVIC SQUARE BACKFLOW TEST EQUIPMENT
CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 2313 WEST STATE ROAD 32
WESTFIELD IN 46074 CHECK NUMBER: 218767
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239034 0345 125 . 00 LANDSCAPING SUPPLIES
Backflow Test Equipment Invoice
2313 State Road 32 W Date Invoice#
Westfield, IN 46074
317-966-2960 3/28/2013 0345
Bill To Ship To
City of Carmel Call Michael when ready
3400 W. 131 st St. 317-443-0841
Carmel,IN 46074
P.O. Number Terms Rep Ship Via F.O.B. Project
IRRIGATION Upon Receipt 3/28/2013 will call
Quantity Item Code Description Price Each Amount
I Calibration Re-calibrate Gauge serial 410071027 125.00 125.00
Sales Tax 7.00% 0.00
Total $125.00
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))
03/28/13 0345 $125.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Backflow Test Equipment
IN SUM OF $
2313 State Road 32 W
Westfield, IN 46074
$125.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 I 0345 I 42-390.341 $125.00 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
//Mo�j,,A r- 0 , 2013
Str&tE@bPm-nj6h*ner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund