224668 09/25/2013 CITY OF CARMEL, INDIANA VENDOR: 355216 Page 1 of 1
ONE CIVIC SQUARE THOMAS L GRANTHAM COMPANY INC
CARMEL, INDIANA 46032 14016 BRITTON PARK ROAD CHECK AMOUNT: $497.50
FISHERS IN 46038
CHECK NUMBER: 224668
CHECK DATE: 9/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 5867 497 . 50 BUILDING REPAIRS & MA
Urantham
THOMAS L. GRANTHAM COMPANY, INC.
14016 Britton Park Road
Fishers, Indiana 46038
317-845-8888
Fax:317-770-6160
Date Invoice#
9/12/2013 5867
Bill To Job Name
Carmel Street Department
3400 W. 131st Street
Carmel, IN 46074
P.O. No. Terms Project#
Net 15 days 42353
Item Quan... Description Rate Amount
Service 3.5 Sales-Service-Allen-9/6/13 135.00 472.50
Materials 1 Material sales-CO& NO2 gasses to test
Sales Tax 7.00% 1.75
Sa1� ax
Phone# Fax#
Federal ID#35-1673094
317-845-8888 317-770-6160 Total $499.25
VOUCHER NO. WARRANT NO.
ALLOWED 20
Thomas L. Grantham Company
IN SUM OF $
14016 Britton Park Road
Fishers, IN 46038
$497.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
T
2201 I 5867 I 43-501.00 $497.50 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
° Frid y Se 013
UVA/W =
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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))
09/12/13 5867 $497.50
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
120
Clerk-Treasurer