222407 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 367110 Page 1 of 1
ONE CIVIC SQUARE GOLDSTREET DESIGNS
CARMEL, INDIANA 46032 CHECK AMOUNT: $616.00
PO BOX 1972
BEND OR 97709 CHECK NUMBER: 222407
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1925 616 . 00 MATERIALS & SUPPLIES
GGL®STREET INVOICE
D E S I G N S Invoice Number 00001925
Payment Terms Net 15 Days
Due Date 7/26/2013
Client
Account Name Carmel,City of P.O.# S03042
Contact Name Teresa Lewis Bill To 760 Third Avenue SW Suite#110
Carmel,IN 46032
Invoice Line Items
Status Line Item'�Descri. . .. .
Qty:1000
Completed FOG Bill Inserts Bill Inserts:8.5x3.66,No Fold $616.00 $616.00 $32
100LB Book,Gloss AQ,4:4(Color Front,Color Back),Bleed
Subtotal
Project Setup $0.00 Shipping/Handling $32.00
Completed Projects $616.00
Current Amount Due
Current Amount Due$648
Payment Methods
Electronic Checks(EFT's),Paper Checks&Credit Card'(Visa, MasterCard,American Express,etc).'Add 4%Processing Fee for credit card
transactions.
Goldstreet Design Agency,inc P.O.BOX 1972 BEND,OR 97709
WWW.GOLDSTREETDESIGNS.COM (866)742-8287
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
t
Payee
367110
GOLDSTREET DESIGNS Purchase Order No.
PO BOX 1972 Terms
BEND, OR 97709 Due Date 7/23/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/23/2013 1925 $616.00
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
Date Officer
i
VOUCHER # 136010 WARRANT # ALLOWED
367110 IN SUM OF $
GOLDSTREET DESIGNS
PO BOX 1972
BEND, OR 97709
Carmel Wastewater Utility
i
� ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
I
1925 01-7200-01 $616.00
Voucher Total $616.00
Cost distribution ledger classification if
claim paid under vehicle highway fund