226341 11/19/2013 CITY OF CARMEL, INDIANA VENDOR: 354857 Page 1 of 1
ONE CIVIC SQUARE HOOSIER PORTABLE RESTROOMS INC
CHECK AMOUNT: $300.00
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CARMEL, INDIANA 46032 2201E 99TH ST
INDIANAPOLIS IN 46280 CHECK NUMBER: 226341
CHECK DATE: 11/19/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 8150 300 . 00 OTHER CONT SERVICES
Hoosier Portable Restrooms Invoice
License #29-031/33/35
2201 E. 99th Street Date Invoice#
Indianapolis, IN 46280 11/5/2013 8150
(317) 844-6919
Bill To: Customer Phone
Carmel Fire Department 317-409-3538
Keith Freer
2 Civic Square
Carmel,IN 46032
Project P.O. No. Terms
Safety Day Due upon receipt,please.
Item Service Dates Quantity Rate Amount
Standard Unit(s)Serviced-... September 21,2013 4 50.00 200.00
Portable Handwashing Stati... 2 50.00 100.00
It is a pleasure working with you!
Total $300.00
hoosierportables.com (317) 844-6919 hoosierportables @gmail.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hoosier Portable Restrooms
IN SUM OF $
2201 E. 99th Street
Indianapolis, IN 46280
$300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
1120 I 8150 I 43-509.00 I $300.00 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
NOV 18 2013
f€
Fire Chief
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
Nhom, 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))
8150 $300.00
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