223636 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 354867 Page 1 of 1
ONE CIVIC SQUARE RUNYON EQUIPMENT RENTAL CHECK AMOUNT: $848.90
CARMEL, INDIANA 46032 410 W CARMEL DRIVE
,roN.`o CARMEL IN 46032 CHECK NUMBER: 223636
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 STREET 38 . 90 276635-1
2201 4231100 STREET -21 . 60 C657
2201 4353099 STREET 151 . 20 276006-1
2201 4353099 STREET 151 . 20 276124-1
2201 4353099 STREET 151 .20 276646-1
2201 4353099 STREET 151 . 20 276650-1
2201 4353099 STREET 54 . 00 276758-1
2201 4353099 STREET 172 . 80 276884-1
�III II IIlll 11111111111111 1 1111111 IN Page I of I
Status: Closed
RU NYOIY 410 WEST CARMEL DRIVE Invoice#: 276635-1
CARMEL,IN 46032 Invoice Date: Tue 8/20/2013
EQUIPMENT RENTrAL www.runyonrental.com Date Out: Tue 8/20/2013 8:48:OOAM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a tool-Rent one" 317-566-2990 Fax Operator: JOEL PROCHNOW
Customer#: 1384 Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by: MARTZ, FREDERICK KENT
Salesman: NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 103-1 PROPANE 60 POUND REFILL Pulled $38.90
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$0.00 $0.00 $38.90 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$38.90 $0.00 $38.90 $0.00 $38.90
You understand that:(a)a is unauthorized for me to lend the Rented Item(s)to any other person;(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel,(d)no electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug,(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned;and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-MARTZ,FREDERICK KENT
Modification# 1
Printed On Tue 8/2012013 5:36:20PM Software by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
111111111111111111111111 IN Page 1 of 1
Status: Closed
®�
CARMEL,IN 46032E DRIVE
Invoice#: 276006-1
Invoice Date: Wed 8/14/2013
EQUIVMENT RENTAL www.runyonrental.com Date Out: Wed 8!14/2013 1:59:OOPM
1-800-276-Tool(8665) 317-566-8888 Phone
"0001 be a tool-Rent one" 317-566-2990 Fax Operator: JOEL PROCHNOW
Customer#: 1384 Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 460 t 4
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by:TABAK, TRAVIS MITCHELL
Salesman: NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 7461#0001 SAW CONCRETE 65 H.P.26"BLADE 407576 Returned 8/1412013 5:38:OOPM $140.00
Meter Out:392.7 Meter In:392.7 Total hours on meter:0.0
4Hrs$140.00 1day$165.00 1week$660.00 4weeks$1,980.00
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$140.00 $11.20 $0.00 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$151.20 $0.00 $151.20 $0.00 $151.20
You understand that:(a)it is unauthorized for me to lend the Rented Item(s)to any other person,(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel,(d)nc electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug;(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned,and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-TABAK,TRAVIS MITCHELL
Modification# 2
Printed On Wed 8/1412013 5:45:40PM Software by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
111111111111111111111111 Page 1 of 1
Status: Closed
a e ® 410 WEST CARMEL DRIVE Invoice#: 276124-1
{� CARMEL,IN 46032 Invoice Date: Thu 8115/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Thu 8/15/2013 1:39:OOPM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't he a tool-Rent one" 317-566-2990 Fax Operator: MEL SPROUSE
Customer#: 1384
Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074
Open Monday-F=riday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by: DAVIS, JOSHUA ALAN
Salesman: NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 7461#0001 SAW CONCRETE 65 H.P.26"BLADE 407576 Returned 8/15/2013 3:03:OOPM $140.00
Meter Out:392.7 Meter In:392.7 Total hours on meter:0.0
4Hrs$140.00-1 day$165.00 /week$660.00 4weeks$1,980.00
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$140.00 $11.20 $0.00 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$151.20 $0.00 $151.20 $0.00 $151.20
You understand that:(a)it is unauthorized for me to fend the Rented Item(s)to any other person;(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel,(d)nc electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug;(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented item(s)have been returned,and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-DAVIS,JOSHUA ALAN
Modification# 3
Printed On Thu 8/1512013 5:33:58PA1 Software by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
111111111111111111111111 IN Page of
Status: Closed
Ps IVsf N 410 WEST CARMEL DRIVE Invoice#: 276646-1
CARMEL,IN 46032 Invoice Date: Tue 8/20/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Tue 8/20/2013 9:08:OOAM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a tool-Rent one" 317-566-2990 Fax Operator: WINNIE HELMS
Customer#: 1384
Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by: OTTINGER, MARK
Salesman: NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 7461#0001 SAW CONCRETE 65 H.P.26"BLADE 407576 Returned 8/20/2013 10:07:OOAM $140.00
Meter Out:392.8 Meter In:392.8 Total hours on meter:0.0
4Hrs$140.00 lday$165.00 lweek$660.00 4weeks$1,980.00
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$140.00 $11.20 $0.00 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$151.20 1 $0.00 $151.20 $0.00 $151.20
You understand that.(a)it is unauthorized for me to lend the Rented Item(s)to any other person,(b)(b)THE RENTED ITEMS)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel;(d)no electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug,(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned,and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-OTTINGER,MARK A
Modification# 3
Printed On Tue 8/20/2013 5:36:26PM Software by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
111111 IIIII 1111111111111111111111111111 Page 1 of 1
®®p® 410 WEST CARMEL DRIVE Status: Closed
® Invoice#: 276758-1
F�®® CARMEL,IN 46032 Invoice Date: Wed 8/21/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Wed 8/21/2013 9:13:OOAM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a tool-Rent one" 317-566-2990 Fax
Operator: WINNIE HELMS
Customer#: 1384 Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by:WILLIAMS, RON
Salesman: NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 5857#0014 LASER LEVEL 12325306 Returned 8/21/2013 3:09:00PM $50.00
4Hrs$40.00 lday$50.00 lweek$200.00 4weeks$600.00
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$50.00 $4.00 $0.00 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$54.00 $0.00 $54.00 $0.00 $54.00
You understand that:(a)it is unauthorized for me to lend the Rented Item(s)to any other person;(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel;(d)no electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug,(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned;and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-WILLIAMS,RON
Modification# 4
Printed On Wed 8/21/2013 5:39:42PM Software by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
Ililli IIIII 18111111111111111111111 IN Page 1 of 1
Status: Closed
410 WEST CARMEL DRIVE Invoice#: 276750-1
CARMEL,IN 46032 Invoice Date: Wed 8/21/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Wed 8/21/2013 9:02:OOAM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a tool-Rent one" 317-566-2990 Fax
Operator: JOEL PROCHNOW
Customer#: 1384 Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by: TABAK, TRAVIS MITCHELL
Salesman:NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 1917#0003 GEORGIA BUGGY 16 CU FT TRACKS 7300526 Returned 8/21/2013 2:41:OOPM $140.00
Meter Out:131.2 Meter In:132.5 Total hours on meter:1.3
4Hrs$110.00 lday$140.00 lweek$560.00 4weeks$1,680.00
CUSTOMER MUST RETURN,ANY EQUIPMENT USED FOR
CONCRETE WORK,CLEAN INSIDE 8 OUT OR YOU WILL
BE CHARGED A CLEANING FEE X
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$140.00 $11.20 $0.00 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$151.20 1 $0.00 $151.20 $0.00 $151.20
You understand that:(a)it is unauthorized for me to lend the Rented Item(s)to any other person,(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel,(d)no electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug;(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned;and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and 1 fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-TABAK,TRAVIS MITCHELL
Modification# 3
Printed On Wed 8/2112013 5:39:37PM Software by Point-of-Rental Systems www.point-of-rentarcom Contract-Params.rpl(1)
RUNYON EQUIPMENT RENTAL Status: Closed
410 WEST CARMEL DRIVE 317-566-8888 Phone Invoice#: c657
CARMEL,IN 46032 317-566-2990 Fax
Invoice Date: Wed 8/21/2013
www.runyonrental.com Will Call: Wed 8/21/2013
Operator: Liz Bowen
Customer#: 1384 Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET Job Descr: Credit on Account
CARMEL,IN 46074
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Open Seven Days a Week
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$0.00 $0.00 $0.00 $0.00 $0.00
Subtotal: Total: Paid: Amount Due:
$0.00 $0.00 $0.00 $21.60 ($21.60)
I�II�II�II I��I��II� I�I�I IIIII'I�I III Page 1 of 1
Status: Closed
IQ U NY®1y 410 WEST CARMEL DRIVE Invoice#: 276884-1
CARMEL,IN 46032 Invoice Date: Thu 8/22/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Thu 8/22/2013 10:26:OOAM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a fool-Rent one" 317-566-2990 Fax Operator: JOEL PROCHNOW
Customer#: 1384 Terms: On Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by:TABAK, TRAVIS MITCHELL
Salesman: NONE Phone:-- E-Mail:
Qty Key Items Ser# Status Returned Date Price
1 6700#0001 SEWER CAMERA ONLY 040223 Returned 8/22/2013 2:56:OOPM $70.00
lday$70.00 lweek$280.00 4weeks$840.00
PLEASE INSPECT CABLES PRIOR TO LEAVING,YOU ARE
LIABLE FOR ANY BROKEN-BENT CABLES OR LOST CUTTERS.X
1 6780-1 SEWER CAMERA LARGE CABLE ONL' Returned 8/22/2013 2:56:OOPM $90.00
4Hrs$90.00 lday$145.00 lweek$580.00 4weeks$1,740.00
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$160.00 $12.80 $0.00 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$172.80 $0.00 $172.80 $0.00 $172.80
You understand that:(a)it is unauthorized for me to lend the Rented Item(s)to any other person,(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel,(d)no electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug,(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned;and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL STREET DEPARTMENT-TABAK,TRAVIS MITCHELL
Modification# 3
Printed On Thu 8/22/2013 5:39:53PM Software by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
VOUCHER NO. WARRANT NO.
ALLOWED 20
Runyon Equipment Rental
IN SUM OF $
410 W. Carmel Drive
Carmel, IN 46032
$848.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
2201 276006-1 43-530.99 $151.20 1 hereby certify that the attached invoice(s), or
2201 276124-1 43-530.99 $151.20 bill(s) is (are) true and correct and that the
2201 276646-1 43-530.99 $151.20
materials or services itemized thereon for
2201 276635-1 42-311.00 $38.90
2201 276758-1 43-530.99 $54.00 which charge is made were ordered and
2201 276650-1 43-530.99 $151.20 received except
2201 c657 42-311.00 ($21.60)
2201 276884-1 43-530.99 $172.80
F i ay, st 23 2Q13
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 276006-1 $151.20
08/15/13 276124-1 $151.20
08/20/13 276646-1 $151.20
08/20/13 276635-1 $38.90
08/21/13 276758-1 $54.00
08/21/13 276650-1 $151.20
08/21/13 c657 ($21.60)
08/22/13 276884-1 $172.80
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