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221551 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 354857 Page 1 of 1 ONE CIVIC SQUARE HOOSIER PORTABLE RESTROOMS INC CHECK AMOUNT: $65.00 CARMEL, INDIANA 46032 2201 E 99TH ST oN.�a INDIANAPOLIS IN 46280 CHECK NUMBER: 221551 CHECK DATE: 7/212013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239039 7444 65 . 00 GENERAL PROGRAM SUPPL i Hoosier Portable Restrooms Invoice License #29-031/33/35 2201 E. 99th Street Date Invoice# Indianapolis, IN 46280 (317) 844-6919 5/28/2013 7444 Bill To: Customer Phone Carmel Clay Parks Department 573-4026 Attn: Dawn Koepper 1411 E 116th St Carmel,IN 46032 Project P.O. No. Terms i River.Heritage Dark Due upon receipt,please. Item Service Dates Quantity Rate Amount Standard Unit(s)Serviced-... June 7,2013 1 65.00 65.00 Po r fi�le res-�mv-vi Ca►m ou+- Mc oCoy IS2�f) 109Co -(�)0- 4239Qa9 It is a pleasure working with you! Total $65.00 hoosierportaUes.com (317) 844-6919 hoosierportables @gmail.com J ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show, kind d of serfice,units, ere performed, dcates service rendered, by whom, rates per day, number of hours, rate N Payee Purchase Order No. Terms 354857 Hoosier Portable Restrooms, Inc. 2201 E. 99th Street Indianapolis, iN 46280 Invoice Invoice Description PO# Amount Date Number (or note attached invoice(s)or bill(s)) $ 65.00 5/28/13 7444 Portable restroom campout i Total $ 65.00 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 5-11-10-1.6 120— Clerk-Treasurer Voucher No. Warrant No. 354857 Hoosier Portable Restrooms, Inc. Allowed 20 2201 E. 99th Street ,~ Indianapolis, iN 46280 In Sum of$ s' $ 65.00 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members X.., Dept# 1096-60 7444 4239039 $ 65.00 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 F,'V,ptr which charge is made were ordered and V . ` -Vii._o • ,�y�• ;;f. received except 20-Jun 2013 Signature $ 65.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund