226800 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 00351163 Page 1 of 1
ONE CIVIC SQUARE ROBY'S INC
CARMEL, INDIANA 46032 9249 CASTLEGATE DRIVE CHECK AMOUNT: $22.00
INDIANAPOLIS IN 46256-1004 CHECK NUMBER: 226800
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4237000 103282 22 . 00 REPAIR PARTS
CONTROL®� DISPATCH # �,°7` O' INVOICE # t
NAME NAME 000/ 43 ATE Since 1955
(CHARGE TO)�dy r��/ /4�„ �^ (WORK AT) /OsgJ �r� 1N PC8600759
ADDRESS / D E OMPLETE PLUMBING SERVIC
L+ a www.rabyspiumbing.com
CITY STATE ZIP CITY STATE Phone:(317)849-9884 Phone:(765)643-3366
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2— 9249 Castlegate Drive 5508 Scatterfield Road
HOME PHONE WORK PHONE HOME PHONE WORK PHONE
ndianapolis, IN 46256 Anderson,IN 46018
NATURE OF CALL
VEN ❑ YES ❑ NO
// �/ AC ANCE OF ESTIMATE
P."1 i.�61 -A7 Q C--) 'CC) P d1 40 V L8� p� SIGNED)
❑ WARRANTY
• . • • • DESCRIPTION
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Purchaser Date
Approval Date.
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I hereby acknowledge the labor charge and material j3ed as listed herein and agree to pay this
invoice upon receipt.Deferred payment shall bear an i; 3rest rate of 1.75%per month.If collection
A T: Warranty Information is made through an attorney,then the purchaser shall pWy a reasonable attorneys fee and all costs
❑CBSh Amount$ incident to such collection.All Sales Final.
❑Check IGNED)
# Acceptance of completed work
S
❑Credit Card Visa MC Disc AmerEx Service Tech
Auth.# TO L
SALES TAX CHARGED ON MATERIAL WHEN APPLICABLE.
PAYMENT DUE UPON RECEIPT
ACCOUNTS PAYABLE VOUCHER
CITY OF CARM EL
An invoice of 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.
00351163 Roby°s, Inc. Terms
9249 Castlegate Drive
Indianapolis, IN 46256
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/31/13 103282 Repair at Inlow Park $ 22.00
Total $ 22.00
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.
00351163 Roby's, Inc. Allowed 20
9249 Castlegate Drive
Indianapolis, IN 46256
In Sum of$
$ 22.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 103282 4237000 $ 22.00 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
27-Nov 2013
Signature
$ 22.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund