224072 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 366289 Page 1 of 1
ONE CIVIC SQUARE P K S CONSTRUCTIONS INC CHECK AMOUNT: $690.00
CARMEL, INDIANA 46032 450 S RITTER AVE SUITE A
INDIANAPOLIS IN 46219 CHECK NUMBER: 224072
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4350100 31561 117 690 . 00 PAINT RM 225 CITY HAL
PKS Construction, Inc. Invoice
450 S. Ritter Avenue, Suite 1A
Invoice Number
Indianapolis, IN 46219
117
Voice: (317) 354-1070
Fax: (317)354-1237 Invoice Date
8/19/2013
Bill To: Carmel City Hall Re: Carmel City Hall 225 Painting
One Civic Square
Carmel IN 46032
I
Job No Customer Job No Customer PO Payment Terms Due Date
P1365 31561 Net 30 days 9/18/2013
Description Price j
Carmel City Hall Room 225 Painting 690.00
D � 0
S E-" 0 9 2013
By
Subtotal: 690.00
Sales Tax: 0.00
Total Amount Due: 690.00
INDIANA RETAIL TAX EXEMPT PAGE 1
City o C armel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 31561
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AJP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
8/6/2013 Paint Room 225
PKS Construction, Inc.
450 South Ritter Ave, Suite A SHIP
VENDOR
Indianapolis, Indiana 46219 TO
CONFIRMATION I BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Paint walls in room 225
Paint (1) hollow metal frame
Paint wood trim on (2) windows and sills $690.00
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Send Invoice To: City of Carmel . f>
Attention: Jeff Barnes -
One Civic Square
Carmel, Indiana 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
1205 4350100 PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY
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))
08/19/13 117 $690.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
PKS Construction, Inc
IN SUM OF $
450 South Ritter Ave., Suite A
Indianapolis, IN 46219
$690.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
31561 117 43-501.00 $690.00
I hereby certify that the attached invoice(s), or
I I
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
Mond September 09, 2013
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund