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Home My WebLink About223636 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