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Home My WebLink About220358 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 361528 Page 1 of 1 i ONE CIVIC SQUARE STAPLES BUSINESS ADVANTAGE CHECK AMOUNT: $4,013.01 �I?o CARMEL, INDIANA 46032 DEPT DET o� PO BOX 83689 CHECK NUMBER: 220358 CHICAGO IL 60696-3689 CHECK DATE: 5/21/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4230200 3197485215 368 . 20 OFFICE SUPPLIES 1091 4463000 3197920716 2, 795 . 40 FURNITURE & FIXTURES 1701 4230200 3198377651 39 . 50 OFFICE SUPPLIES 1091 4230200 3198377653 89 . 82 OFFICE SUPPLIES 1091 4230200 3198377655 59 .49 OFFICE SUPPLIES 911 4230200 3199055344 99 . 89 OFFICE SUPPLIES 1301 4230200 3199055345 519 . 27 OFFICE SUPPLIES 1701 4230200 3199055346 41 .44 OFFICE SUPPLIES INVOICE<:DATE. ;CUSTOMER:::>' SUMMARY<INVOICE` 5754/13 DET 1061088 8025503372 PLEASE..PAY BY. TERMS: AMOUNT.:DUE 6/03/13 Net 30 Days 660-60 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: MARIE DOAN 1 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 3 CIVIC SQUARE Budget Ctr: 110 - POLICE DEPARTMENT Invoice Number: 3199055344 P 0 Number: Release: Order: 7099734213-000-001 Ordered by: MARIE DOAN Job: Order Date: 5/02/13 Urcler nit Ship Unit. Exf&zgdF� Line Item Number Description' Qty Qty Meal. Qty Price ' Price 1 917913 BROTHER TZE-1312PK 12MM BLKCLR 1 PK 1 28.39 28.39 2 917881 BROTHER TZE-2312PK 12MM BKWHT 2 PK 2 28.39 56.78 3 917879 BROTHER TZE-232 12MM RED ON WH 1 EA 1 14.72 14.72 rep ax. - o a Total: .. 99.89` Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0001988-0049879-0000003 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)) 05/04/13 3199055344 $99.89 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Staples Advantage Dept. DET IN SUM OF $ P.O. Box 83689 Chicago, IL 60696-3689 $99.89 ON ACCOUNT OF APPROPRIATION FOR Project 2013-911 Task 2013-2 PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 911 I 3199055344 I 42-302.00 I $99.89 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, May 15, 2013 a'rl� -D-X-le Major Title Cost distribution ledger classification if claim paid motor vehicle highway fund tNVO10E DATE.. CUSTOMER SUMMARY INVOICE. 5/04/13 DET 1061088 8025503372 6/03/13 Net 30 Days 660.60 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: BONNIE LEWIS 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 130 - CITY COURT Invoice Number: 3199055345 P 0 Number: Release: Order: 7099652603-000-001 Ordered by: BONNIE LEWIS Job: Order Date: 5/01/13 Urcier. Urder ni ip ni x Lirie''-Item Number 'Description Qt Qt Meas Qt 'Pricece Price 1 915714 KLEENEX FACIAL TISSUE 36/CT 1 CT 1 63.01 63.01 2 234062 XEROX 8.5X11 COPY/PRINT CS 4 CT 4 44.72 178.88 3 640031 VELOCITY MECH PENCIL .5MM 1 DZ 1 12.48 12.48 4 804574 HP CE255A BLACK TONER 2 EA 2 132.45 264.90 Freight: - ax' - o a Total: 519.27 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0001989-0049879-0000004 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) 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 (5:;, D P Purchase Order No. D EPT 1��"r- 1 g� Terms Co loo Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) S 3f9?0S�39 ' F iC-C w r S 5 a? Total 5 � - 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 IN SUM OF $ Dc_ P D61 B (Y 4 v9 C Y1iCfq(�,0 E ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I 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 20 TgTN� le Cost distribution ledger classification if claim paid motor vehicle highway fund ` INVOICE DATE:.. SUMMARY:>INV.OICE APR 17 2013 I 4/13/13 DET 1061088 8025281386 5/13/13 Net 30 Days 368.20 L INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: JEANINE POTTRIDGE 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1091-4230200 MCC ADMINISTRATION Invoice Number: 3197485215 P 0 Number: MC003986 Release: Order: 7098479827-000-001 Ordered by: JEANINE POTTRIDGE Job: Order Date: 4/08/13 Order Orcler B/O Unit Ship Unit E-xTe—nB5a-j Line Item Number Description Oty Oty Meas Oty Price Price 1 833860 *10 CASE* SPLS 8. 5X11 COPY 1 PK 1 368. 20 368. 20 #MC003986 Freight: ax - o a Total: 368.20 Purchase f- n Dsscript;on (,;(� J P� P.O.# , �Q PorF G.L.# BudjGet Line uescr Purchaser Date Approval Da" Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0013566-0014569-0000003 C 77 A�"T�� INVOICE%DATE" CUSTOMER "'<> ' SUMMARY"INVOICE d� 4/20/13 DET 1061088 8025352700 AP y R 2 5 2013 5 20 13 Net 30 Das 2,795.40 .Y. INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: DAWN KOEPPER 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1125-4230200 Invoice Number: 3197920716 P 0 Number: 29545 Release: Order: 113997427-000-002 Ordered by: DAWN KOEPPER Job: Order Date: 3/22/13 r order Unit Ship- Unit -Extended, Line-Item Number Description Qty Qty Meas Qty Price Price Kit -Linear Mat Chrome 3pack HLINEARC3 OPTION 2 Furn. Ref . No. 0003586074-0011 ?0011? 13 421074 34 Lgth Modesty Panel for 1 EA 1 269.55 269.55 P e n i n s u I a F r o s I e d N i c k I HPC180G OPTION 2 Furn. Ret . No. 0003586074-0012 ?0012? rep '. . . - o a Total'. 2 795.40 Backorder of 0113997427 Purchase Lewiption dFFICL FQ(4)qQ IZE-jyIC DlV Mc_1R P.O.# aC154a P orb G.L.# 1091-UL465co�o Budget Line Descr Ed 1� LCD �L� �c 1017 u�S t � � Purchaser Date Approval Date Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 3 Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 0015195-0044395-0000005 r. tECEI r✓ ED 4 20113 DATE: . EUSDIET 1061088 SUS 80253 27 011E APR 2 5 2013 5/20/13 Net 30 Days 2,795.40 INVOIC DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: DAWN KOEPPER 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 'I Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1125-4230200 Invoice Number: 3197920716 P 0 Number: 29545 Release: Order: 113997427-000-002 Ordered by: DAWN KOEPPER Job: Order Date: 3/22/13 r order Unit Ship- m x Line Item Number Descri ption Qty Qty Meas Qty Price Price 2 421074 Mobile Full Height Ped BBF 1 EA 1 320.40 320.40 15-58W x 22-34D H105102 .Z LAM: Columbian Walnut Z LAM: Columbian Walnut OPTION 2 Furn. Ret . No. 0003586074-0001 ?0001? 3 421074 72Wx3042Dx29-12H Rudder 1 EA 1 418.95 418.95 Peninsula wEnd Pnl LH H105206L .Z LAM: Columbian Walnul Z LAM: Columbian Walnul OPTION 2 Furn. Ref . No. 0003586074-0002 ?0002? 4 421074 Bookcase Hutch 36'W x 37-18'H 1 EA 1 213.75 213.75 H105292 .Z LAM: Columbian Walnut Z LAM: Columbian Walnut OPTION 2 Furn. Ref. No. 0003586074-0003 ?0003? 5 421074 72Wx14-58Dx37-18H Slack-on 1 EA 1 623. 70 623.70 Slg - Frosted Doors H10534G .Z LAM: Columbian Walnut Z LAM: Columbian Walnut OPTION 2 Furn. Rei . No. 0003586074-0004 ?0004? 6 421074 Bridge 47W x 24D x 29-12H 1 EA 1 138.60 138.60 H10570 .Z LAM: Columbian Walnut Z LAM: Columbian Walnut OPTION 2 Furn. Ref . No. 0003586074-0005 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 0015193-0044395-0000003 INVOICE DATE. CUSTOMER:::::.:: SUMMARY JNVOICE: P CRIVED —47-275 -13 DET 1061088 8025352700 AMOUNT�::DDY-. . APR 5 Z013 5/20/13 Net 30 Days 2.795.40 2 iwoic TAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: DAWN KOEPPER 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1125-4230200 Invoice Number: 3197920716 P 0 Number: 29545 Release: Order: 113997427-000-002 Ordered by: DAWN KOEPPER Job: Order Date: 3/22/13 FIYFae-r Order B/O Unit Sh'ip Unit hxf6535T1 Line Qty '.Price Price Item Nurnber -Description Qt y Qt y Mess ?0005? 7 4 2 1 0 7 4 B a c k e n c l o s u r e f o r 72'W S t a c k 1 EA 1 87.75 87.75 on Slorage H 1 05856 .Z LAM: Columbian Walnut OPTION 2 Furn. Ref. No. 0003586074-0006 ?0006? 8 421074 72Wx24Dx29-1 2H Single Ped 1 EA 1 465.30 465.30 Credenza RH FF Ped H105903R .Z LAM: Columbian Walnut Z LAM: Columbian Walnut OPTION 2 Furn. Ref. No. 0003586074-0007 ?0007? 9 421074 Tackboard for 72'W Stack on 1 EA 1 110. 25 110. 25 S t o r a g e Back E n c l o s u r e H90056 $(3) GRADE: Fabric Grade III .PN FABRIC: Appoint 15 COLOR: Dune OPTION 2 Furn. Ref . No. 0003586074-0008 ?0008? 10 421074 Tasklight 42W 1 EA 1 88.20 88.20 HH870942 OPTION 2 Furn. Ref. No. 0003586074-0009 ?0009? 11 421074 Field Install DwrDt 2 EA 2 1845 36.90 Kit-Linear Mat Chrome 2pack HLINEARC2 OPTION 2 Furn. Ref. No. 0003586074-0010 ?0010? 12 421074 Field Install D w r D r 1 EA 1 22.05 22.05 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 2 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0015194-0044395-0000004 RE 'F,TN F+�D INVOICE DATE CUSTOMER SUMMARY.INVOICE MAY 0 2 2013 4 27 13 DET 1061088 8025425375 PAY B7 TERMS AMOUNT D 5 27 13 Net 30 Days 149.31 BX: lNVOl CE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: JEANINE POTTRIDGE 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1091-4230200 MCC ADMINISTRATION Invoice Number: 3198377653 P 0 Number: MC004039 Release: Order: 7099340694-000-001 Ordered by: JEANINE POTTRIDGE Job: Order Date: 4/25/13 r r r r Fs/u. unit Ship Unit Exte Line Item Number Description City Oty Meas Oty Price Price 1 744100 3TAB 14PT MAN FF LTR 50CT 1 BX 1 9.04 9. 04 2 324337 NIKO MECH PENCIL 0.7MM ASST 1 DZ 1 8. 44 8.44 3 512685 NOTE CUBE 2X2 3PK 1 PK 1 7. 10 7. 10 4 452170 THERMAL POS ROLLS - 10/PK 1 PK 1 21.68 21. 68 5 AAGSW200-00 2013 NINTH ATAGLNC DESKPD 22X17 3 3 EA 14.69 .00 6 677045 SPLS LTR LAMINATING POUCH 50PK 3 PK 3 4. 50 13.50 7 480114 144CT SMALL BINDER CLIPS 6 PK 6 1. 78 10.68 8 525923 CLIP PAPER STL GIANT .045 12 BX 12 .34 4.08 9 566942 CLIP MINI BINDER 315 BK 144CT 6 PK 6 1 . 29 7.74 10 525881 CLIP PAPER STL #11.034 12 BX 12 .02 . 24 11 899631 23X17 PERPETUAL CALENDAR 1 1 EA 59.49 .00 12 852479 REMARX DE MARKER 6PK ASST 1 PK 1 5.49 5.49 13 272153 ERASER-DRY ERASE 1 EA 1 1 .83 1 .83 Freight: Tax:( - o a : Total: 89.82 Balance to follow P:lrchasa r Ree suPP>JEs MCC_ P.O.# _Qor F G.L.# I0Rl-4-a�aC �a+rlet De.scr Purchaser Cate Approval __Cute Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0003803-0034479-0000003 EHY4 CE DATE CUSTOMER SUMMARY INVOICE 9 0 A" 13 DET 1061088 8025425375 WOW13 Net 30 Days 149.31 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CARMEL CLAY PARKS AND RECREATION CITY OF CARMEL PAULA SCHLEMMER ATTN: JEANINE POTTRIDGE 1411 E 116TH ST 1235 CENTRAL PARK DR E CARMEL, IN 46032 DLV BEFORE 4PM CARMEL, IN 46032 Bill to Account: 1030597 Ship to Account: 1235 CNTRL PK E Budget Ctr: 1091-4230200 MCC ADMINISTRATION Invoice Number: 3198377655 P 0 Number: MC004039 Release: Order: 7099340694-000-003 Ordered by: JEANINE POTTRIDGE Job: Order Date: 4/25/13 FD_r_(Rir Urder B/U Unit Ship Unit Extended Line Item Number Description Qty Qty Meas Qty Price Price 11 899631 23X17 PERPETUAL CALENDAR 1 EA 1 59.49 59.49 Freight: ax:( .0000 .00 Sub-Total: Total: 59.49 - D-C-scla$e OKICE sUPPU is Mac i�,. rripuon P.o.# me 004039 P o� �.L.# 1 O`i l - 423o200 C,iat@ Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0003804-0034479-0000004 i ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 361528 Staples Business Advantage Terms Dept DIET 2368 P.O. Box 83689 Chicago, IL 60696-3689 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO # Amount 4/13/13 3197485215 Copy paper 29620 $ 368.20 4/20/13 3197920716 Office Furniture MCC Div Mgr 29542 $ 2,795.40 4/27/13 3198377653 Office supplies MCC $ 89.82 4/27/13 3198377655 Office supplies MCC $ 59.49 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 TOTAL $ 3,312.91 20_ Clerk-Treasurer Voucher No. _—. Warrant No. 361528 Staples Business Advantage Allowed 20 Dept DIET 2368 P.O. Box 83689 in Sum of$ Chicago, IL 60696-3689 $ 3,312.91 Total ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT Dept# 1091 3197485215 4230200 $ 368.20 1 hi s hereby certify that the correct as d invoice that the or 1091 3197920716 4463000 $ 2,789.$0 materials or services itemized thereon for 1091 3198377653 4230200 $ 1091 3198377655 4230200 $ 59.49 which charge is made were ordered and received except 16-May 2013 Signature $ 3,312.91 Accounts Payable Coordinator Title Cost distribution ledger classification if claim paid motor vehicle highway fund INVOICE DATE-.:: CUSTOMER SUMMARY':INVOICE 1w 4/27/13 DET 1061088 8025425374 PLEASExPAY BY TERMS 5727/13 Net 30 Days 39.50 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: JEFF BARNES 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 1205-DOA Invoice Number: 3198377651 P 0 Number: COUNCIL WATER Release: CARMEL COUNCIL H2O Order: . 7099255085-000-001 Ordered by: JEFF BARNES Job: Order Date: 4/23/13 r IF Ur der B/U Unit Ship Unit ERT&05T] Line Item Number Description Qty Qty Meas Oty Price Price 1 571863 WATER PURFIED PURE LIFE .5LBOT 10 CT 10 3.95 39.50 Freight: ax: . - o a : Total: 39-50 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DIET PO Box 83689, Chicago IL 60696-3689 0013689-0014638-0000003 INVOICE DATE CUSTOMER -- SUMMARY INVOICE 574/13 DET 1061088 8025503372 PLEASE PAY BY TERMS - AlMOUNT :DOE— wwwwwomm- 6/03/13 Net 30 Days 660.60 INVOICE DETAIL Staples Advantage Federal ID #:04-3390816 CITY OF CARMEL-NJPA CITY OF CARMEL JIM SPELBRING ATTN: ANN DAVIS 1 CIVIC SQUARE 1 CIVIC SQUARE CARMEL, IN 46032 DELIVER BY 4PM CARMEL, IN 46032 Bill to Account: 1030382 Ship to Account: 1 CIVIC SQUARE Budget Ctr: 140 - COMMON COUNCIL Invoice Number: 3199055346 P 0 Number: Release: Order: 7099615423-000-001 Ordered by: ANN DAVIS Job: Order Date: 5/01/13 F17"Er r ni Ship Un i t ERfaidli5a_l Line Item Number Description Qty Oty Meas Qty Price Price 1 163352 FOLDER HGING LGL STD 1/3 3 BX 3 7. 25 21 .75 2 636025 POST- IT SS NOTES 3X3 TROP BRZ 1 PK 1 17.07 17.07 3 202648 SOFT SOAP 7.5 OZ PUMP 1 EA 1 1 .59 1 .59 4 380435 SPLS 2IN HANG TAB CLEAR 50 1 PK 1 1 .03 1 .03 IF reig Tax:( _00 Sub-Total: Total: 41.44 Customer Service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4104 Page: 1 Make checks payable to Staples Advantage, Dept DET PO Box 83689, Chicago IL 60696-3689 0001990-0049879-0000005 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) 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)) / to r! Total 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 VOUCHER NO. WARRANT NO. ALLOWED 20 s IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR � S Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT 5UV DEPT.# I 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 20 Signat r I' Title Cost distribution ledger classification if claim paid motor vehicle highway fund