223609 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 364564 Page 1 of 1
0 ONE CIVIC SQUARE RICHARD PIFER
CARMEL, INDIANA 46032 1466 N 600 w CHECK AMOUNT: $25.77
+r,ybH moo.` GREENFIELD IN 46140 CHECK NUMBER: 223609
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239099 22 . 00 OTHER MISCELLANOUS
2201 4342100 3 . 77 POSTAGE
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CARMEL RETAIL STORE �5\
CARMEL, Indiana
460329998• -
1740350814-0094
08/14/2013 (800)275-8777 11 :32:17 AM
Sales Receipt
Product Sale Unit Final
Description. Qty Price Price
WEST LAFAYETTE IN 47907` $3.77
Zone-1
First-Class Mail Parcel
12.20 oz.
Scheduled Delivery Day: Fri
08/16/13
PID #:
9574 2109 2177 3226 4149 50
Issue PVI: $3.77
Total : $3.77
Paid-by:
- , .$3.77.•
Account #: XXXXXXXXXX'
Approval #: 525247
Transaction #: 973
239030911713134704634
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. _ Copy
ant and Pest Diagnostic Laboratory ����� Office Use Only: Date received:
LSPS-Room 101, Purdue University Sample#
915 W.State Street u N I v E R s t T r
West Lafayette,Indiana 47907-2054 Account No.
(765)494-7071 FAX:(765)494-3958 (PPDL-1-W) 7/03 Date:
http://www.ppol.purdue.edu p
Submitter's Name f�_'tf k 5 1 Client's Name
Business ('" <A-V-elf- F,�Vf Business
Address N J 31 Address
City/State/Zip ��.�(It�[,I V Y 07`1 City/State/Zip
County HNM; 666) Phone(&A 6rD - County Phone ( )
Fax ( ) E-Mail �, Fax ( ) E-Mail
Please include a check or:monel:b der(payable to Purdue-University)for 11 Mail replyto: ❑Submitter ❑Client
per sample:($22 out of state cI ~ Y '-kotsEND"CASH ;Additional charges
Fax reply to: O Submitter O Client
for serotogicai testmgSand drat : - exceptlonai_amounts,of time
and resources maybe,assesr', r` Subihitter Tp Client E-Mall reply to: (]Submitter ❑Client
Information about Submitter/Ciien'!n'I and client):
r .
Submitter Client g, G y
Check information desired:
Extension E_.
HomeownrO' Problem identification
/H
Farmer tpt 4 aer Specimen identification
DealerAr Control recommendations
Golf Cc
} ?e ° Other
— rs ; r.,•
Lands
Greer
e�
Plant or Host: *` �O N � ; `
Location(choose or ,a iN o;,, �
tw /�
— In dwelling -
- Tree/Shrub
— Turf/Lawn a
— Golf course — �ti _ �r �e�e ar��9'9
Flower bed — AquaL i = )_' a- •,� , ,v� a Qs8
— Vegetable garden — Stored grair ;a
— Field/Farm — Other
For
Plant type: Plant size: Flown =
— Tree _ Deciduous Height s;
— Shrub _ Evergreen Width Moriu
— Vine Size
_ Groundcover
Herbaceous Unique features(bark,leaves,odor,thorns,etc.):
Additional Plant and Site Information
Approximate age: N't, ight: Number of years at present site:
Exposure: —Full sun —Partial shade —Full shade _Windy —Protected Irrigation frequency: O^ i
Root disturbance from:—sidewalks/driveways construction activities(describe)
•
Size of planting: %Plants affected: SD Date first noticed problem:
Date planted: Tillage practices: Previous crop:
Chemicals/fertilizers applied(past 2 years)(include rates):
Soil type: _sandy clay _silt —loam — organic Soil pH:
DESCRIBE THE PROBLEM (Include symptoms,plant parts affected,pattern of occurrence, etc. Attach separate sheet if necessary):
e also ajobkm,5. 6(31 Sr 5T 4- 'Fe olio Ad 1
IF
Your Tentative diagnosisAD:
Purdue University Cooperative Extension Service Print Form
PRINT ONE COPY AND INCLUDE WITH SAMPLE;PRINT ONE COPY FOR YOUR RECORDS
VOUCHER NO. _ WARRANT NO.
ALLOWED 20
Parks Pifer
IN SUM OF $
c/o Carmel Street Department
$25.77
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
r
2201 43-420.00 j $3.77 1 hereby certify that the attached invoice(s), or
2201 42-390.99 $22.00 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
Fri August 23, 2013
Sheet Com i sioner
�tr�,e ommissloner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
08/14/13 $3.77
08/15/13 $22.00
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
, 20
Clerk-Treasurer