219699 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 365281 Page 1 of 1
s 0 ONE CIVIC SQUARE D&S CUSTOM COVERS CHECK AMOUNT: $188.76
CARMEL, INDIANA 46032 3055 KINGWOOD ROAD
o� ROCKWOOD PA 15557 CHECK NUMBER: 219699
CHECK DATE: 517/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 4901 188 . 76 AUTO REPAIR & MAINTEN
1
Invoice
Date Invoice#
s' l
3055 Kingwood Rd.
S Rockwood,PA 15557 1/24/2013 4901 CU om covaos
tel. 814,926.4075
cell.814.442.0291
4 ', fax.814.926.3320
email.davew @dscustomcovers.com
\_wet)v.' .dscustomcovers.com
Bill To Ship To
Cannel Fire Department Carmel Fire Department
Bob VanVoorst Bob VanVoorst
2 Civic Square 2 Civic Square
Cannel Indiana.46032 Carmel Indiana 46032
P.O. No.
E-41
Item Description Qty Rate Amount
0 Remove old fasteners from back flaps. Install new Teflon buckles 165.00 165.00
at the locations, Labor 75.00,plus 6 buckles X 15.00 per buckle
=90.00
Shipping Shipping 23.76 23.76
Invoice Please pay from this Bill.Thank You 0.00 0.00
Total $188.76
IN}} . *
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))
4901 E44 $188.76
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
D & S Custom Covers
IN SUM OF $
3055 Kingwood Road
Rockwood, PA 15557
$188.76
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 I 4901 I 43-510.00 I $188.76 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
MAY 6 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund