226808 12/03/2013 �« CITY OF CARMEL, INDIANA VENDOR: 357097 Page 1 of 1
ONE CIVIC SQUARE SERVICE FIRST CLEANING, INC CHECK AMOUNT: $200.00
?o CARMEL, INDIANA 46032 PAYMENT PROCESSING CENTER
32145 BROOKSTONE DRIVE CHECK NUMBER: 226808
WESLEY CHAPEL FL 33545-1656
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4350600 153330 200 . 00 CLEANING SERVICES
Professionally Unique Services d/b/a
Service First Cleaning
' FOR YOUR IMAGE FOR YOUR HEALTH Invoice
-' Payment Processing Center Order No: 153330
E.Fr c X I E i ,�1� -F 32145 Brookstone Drive
. C t_E A N t N G Start StaTi Wesley Chapel, FL 33545 Ref t Time:
me:
Visit us at www.servicefirstcleaning.com End Time:
Customer Info. Service Location JoWnfo .
Name. Carmel Treasurers Department Carmel Treasurer's Department Order Group: Commercial
Phone: Order SubGroup:
One Civic Square Janitorial Cleaning
Alt 1 CARMEL,IN 46032 :Furniture: __ _....
An 2: (317)571-2414 Gross Street: --
QTY Description. PRICE AMOUNT
1 Janitorial-For the month of December 200.00 200.00
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Notes:
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SUBTOTAL $200.00
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TAX
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SERVICE FIRT CLEANING WILL NOT BE LIABLE FOR CONDITIONS BEYOND OUR CONTROL. TOTAL $200.00
INCLUDING THOSE CONDITIONS THAT EXIST PRIOR TO CLEAN ING.Customers should be careful in . --- - - - - - - - -
the event the cleaning service specifications include floor care,carpet care services,as floors may be ADDITIONAL
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slippery due to damp conditions.
.............................._.................................................................................................................................................................................................................................................._........................................................._..... GRAND TOTAL
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PAYMENT AMT
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Work Performed By Date:
PAYMENT TYPE
REF.NO.
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Authorization Signature Date: BALANCE DUE
Thank you for your business
Date: 12/2/2013
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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))
Total
I 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
IN SUM OF $
1nJe5 -
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
t �JC� � p7j 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
s> -
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund