222582 07/30/2013i
wf CITY OF CARMEL, INDIANA VENDOR: 354687 Page 1 of 1
}. ONE CIVIC SQUARE STA.43 FUND
CARMEL, INDIANA 46032 3242 EAST 106TH STREET CHECK AMOUNT: $197.20
CARMEL IN 46033
CHECK NUMBER: 222582
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4235000 197 . 20 BUILDING MATERIAL
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COX INTERIOR, INC.
INVOICE _ •�,���;� �4 �
SOLD TO.CUSTOMER ACCT# 1> DATE
NAME:
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ADDRESS:
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5ALE/DEL CODE: PO#: JOB#/LOT#:
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Quantity Quantity BO part# SIZE-flESCRIP I ION Price
Unit mount
Ordered Shipped
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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))
$197.20
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
Station 43 Station Fund
IN SUM OF $
$197.20
ON ACt- IJNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
r
1120 I I 42-350.00 I $197.20 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
JUL _�n�'
J/V�."
All
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund