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Home My WebLink About227337 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 00350164 Page 1 of 1 ONE CIVIC SQUARE F E HARDING ASPHALT CO, INC CHECK AMOUNT: $1,073.05 CARMEL, INDIANA 46032 10151 HAGUE ROAD !c° INDIANAPOLIS IN 46256 CHECK NUMBER: 227337 <IOM 0 CHECK DATE: 12117/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4236300 STREET 1, 073 . 05 BITUMINOUS MATERIALS STATEMENT �r TM 5145 East 96th Street Indianapolis,Indiana 46240 (317)849-9666 www.hardingasphalt.com i ACCOUNT NO. i i CARMEL STREET DEPARTMENT CAR210 3400 W. 131ST ST. STATEMENT DATE CARMEL, IN 46074 11/30/13 �. -a ru DATE REFERENCE CHARGES CREDITS BALANCE 10/01/13 111473 358.45 358.45 10/01/13 111474 136.79 495.24 10/02/13 111486 51.35 546.59 10/03/13 111506 52.00 598.59 10/04/13 111515 50.70 649.29 10/07/13 111529 52.65 701.94 10/08/13 111537 53.95 755.89 10/09/13 111553 52.00 807.89 10/10/13 111576 51.35 859.24 10/11/13 111585 51.35 910.59 , 10/14/13 111599 69.55 °" -9,80.14 j. 10/15/13 111613 37.70 �� 017.•84 10/18/13 111652 53.30 ., 1071 1�4 10/21/13 111666 110.06 '' 1181.141 i 10/22/13 111688 136.79 1317.93; 10/24/13 111714 113.92 X1,431.85`' 10/29/13 111716 163.35 1595, 20 � 10/25/13 111721 163.90f ''1759//10 10/28/13 111769 51.35 - - -1810.45 11/01/13 111813 495.55 2306.00 11/04/13 111819 50.70 2356.70 - 11/08/13 111869 52.00 2408.70 11/14/13 111934 367.37 2776.07 11/15/13 111966 191.95 2968.02 11/18/13 111977 35.75 3003.77 11/19/13 111989 56.65 3060.42 11/20/13 112002 110.00 3170.42 0-30 DAYS 31-60 DAYS 61-90 DAYS OVER ACCUM. BALANCE 90 DAYS FINANCE CHG. DUE CONT'D g i ANALYSIS OF BALANCE DUE A FINANCE CHARGE OF V/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18 WILL BE INCURRED ON ALL PAST DUE AMOUNTS. LASER BUSINESS FORMS INC. (317)915-5000 1 STATEMENT TM N, d 5145 East 96th Street Indianapolis,Indiana 46240 (317)849-9666 www.hardingasphalt.com ACCOUNT NO. CARMEL STREET DEPARTMENT CAR210 3400 W. 131ST ST. STATEMENT DATE CARMEL, IN 46074 11/30/13 DATE REFERENCE CHARGES CREDITS BALANCE 11/21/13 112024 35.75 3206.17 11/22/13 112033 35.75 3241.92 11/25/13 112043 52.65 3294.57 11/26/13 112062 33.15 3327.72 11/27/13 112071 33.15 3360.87 I' �• i � I l � m 0-30 DAYS 31-60 DAYS 61-90 DAYS OVER ACCUM. BALANCE 90 DAYS FINANCE CHG. DUE 1550.42 1810.45 .00 .00, .00 3360.87 _r YOUR ACCOUNT IS PAST DUE, PLEASE REMIT i ANALYSIS OF BALANCE DUE A FINANCE CHARGE OF V/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18% WILL BE INCURRED ON ALL PAST DUE AMOUNTS. i LASER BUSINESS FORMS INC. (317)915-5000 i } DATE : 1 l°/01/-13 � ,� � 10151 Hague Road � Indianapolis, Indiana 46256 T�t ' (317)849-9666 '° nb lyd"Ti o.,11ijl-ir.; www.hardingasphalt.com ** INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA 1 Sty Ord -Date- ShiD--,-Dat-eA --Shin Via,- Sub- Acc=t Cu-st Ord #-,Slsman AClk-�-- Terms�- CCpPa - �- Item # rt- — Order d - f e Shl ea D e s c r it t. o r Unit Prc, Ext INVOICE hNVOICE' INVOICE INVOICE 292899 _ 12SF } 9 Ol 9 . 01 X12 SURFACE FINE#302 55 . 00 j 495 55 TN I a w r Ok ft is i , Ty i 1 � __ Sa1es __-Tax.-Fr-e �-ht--_.____Misc -GD Deposit 495 . 55 a e; _ e ; 495. 55 A FINANCE CHARGE OF 11/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS.CUSTOMER SHALL BE LIABLE PLEASE REMIT TO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF A �� 10151 Hague Road DATE : _1 l� ® 'a � N Indianapolis, Indiana 46256 rh, �,. , N '� (317)849-9666 I C—�:n= i i-18 19 '/A'g-fff i� .,, Ifir-t, www.hardingasphalt.com ** INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA 1 St,, Ord Dates ShD .Datea.-_Sh p ,Via,. ,�! Sub Acct'° Cu-st Ord #_'--- -lsman�' Clkt Terms "P 017 11 /04/11i Item #. - -- Ordered- Shi ed D e s =c ,-- t i o n 'T --Unit Prci° INVOICE INVOICE ! INVOICE INVOICE 1 ) 292'974 a � 12S 78 . 78 12' SURFACE#3.°OOC 65 . 00 50 . 70 TN P } I E f 1 a f E F e .""' 3 Yn [� i - , 4 E —x AWoe ? WE., l Y_ m � a. =� I° a W Sales- i -------T-ax3ytFrei—ht - Misc- CD= - -De pos-it ----- -- -C-a Sh—C D--"-- TOTAL 50 . 70 z._ [ 50-,. 70 A FINANCE CHARGE OF V12%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMIT TO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF �A Q Ir I e A F� P 10151 Hague Road DATE :__1 1/0 f3/1 Indianapolis, Indiana 46256 M° (317)849-9666 OEC It ,l f1F� www.hardingasphalt.com ** INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA St- Ord- Date :.Shp --Date-� - Ship Via - Sub Acct CUst Ord- # ,,S-1sman-;' C1-k" Terms, CP`Pc4 Ordered -S'hyirj�ed D e s c r i t i o n Unit Prc Ext INVOICE INVOICE INVOICE e INVOICE 4 293243 12S 80 (12 SURFACE#3`<O�OC 65 . 00 � 52 . 00 TN P I f in zl� jl S ev w A' Q2 , 'm � ' { Xa AM g .; ' a � 10 Q.:. �.. - -- - --Sal e-s - Tax- C-D----,, -Deposit - Cash—CD TOTAL 52 . 0 0 A ti A FINANCE CHARGE OF 11/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF �a 191, 10151 Hague Road DATE 1 Y-/l , / P. ¢, ,, Indianapolis, Indiana 46256 e TM ; t�> (317)849-9666 www.hardingasphalt.com INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ( 317 ) 733-2001 Tax Juris : 0001 INDIANA ATTN BONNIE S 01 1 1 zi 5 /jj "' 1 1 i Ord #-,`�S1sman;' Cl_k Terms-. C�p� St, Ord.. Date Shp , Ship -Vla- �' Sub- Acct Cost- Item ff - 0-rdezed h-i0b'ed' u e 5 c r h L 1 ° 6 6nUrt Yrc E, t. INVOICE INVOICE ) INVOICE INVOICE 293634 12SF 3 . 49 . 3 . 49 12 SURFACE F=INE#302 55 . 00 j 191 9.5 TN qo E s a i E I l � E { Sales-- - Tax Freight - Misc CD -Deposit- Cash "CD TOTAL 191 . 95 A FINANCE CHARGE OF V/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS.CUSTOMER SHALL BE LIABLE PLEASE REMIT TO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF yk v '.,� � &, � 10151 Hague Road DATE : 11/18/13 Indianapolis, Indiana 46256 ti, (317)849-9666 Q I E www.hardingasphalt.com INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA 1 St Ord Date.- Shp, Date's--'Sh1 Via.-- tt Sub Acct Gust Ord--U Slsmand Clk� --Terms-- CD I-tem .# Ordered - him Yed D e s -c r t 1 0 n Unit Prc' Ext INVOICE INVOIC°E' INVOICE INVOICE 1 293774 I _" 125 ', 55 . 55 X12 _.SURFACE#3'OOC - 65 . 00 l 35 ..75 TN 1 I 1 P X. e, e o. r e i 1 i I Sales-- --Tax�,Fr ight = Misc CD Deposit Cash-'CD TOTAL 35 . 75 35. 75 A FINANCE CHARGE OF 1'/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS.CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF °1 M "[� 10151 Hague Road DATE• 3 Indianapolis, Indiana 46256 rM'° y (317)849-9666 —,fir 9 r' �,��(`ls��! `.t),��(jr�.', www.hardingasphalt.com ** INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA 1 St I Ord- Date, Shp Date Shib-Via,- Sub Acct C-ust Ord # lsman Clk�' Terms~ CPPq Item # - `= - Ordered-, `7�Sh-ipped D °e s c r- 1D t o:, n Unit PrdT Ext INVOICE INVOICE ;INVOICE hNV010E � X293823 12SF ; 'l 03 i 1 . 03 X1275 SURFACE FaINE#302 55 . 00 56 65 TN a Fl r s° i r a I --Sales TaSSx-F,re aht - Misc CD,�- Deposit -- ` Cash---CD TOTAL " A FINANCE CHARGE OF 11/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF � @� a 10151 Hague Road Indianapolis, Indiana 46256 t (317)849-9666 www.hardingasphalt.com ** INVOICE BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA St Ord.- Date,! Shp Date -Shi Via, Stub Acct Cust -Ord- #" lsmdn-'C1k-" -Terms C Pc: 11 Ordered- -- hi coed D e s -�c r i� t i t: 0-n,, � F Unit Prc'! Ext INVOICE INVOICE j INVOICE IfNVOICE E I 293932 i 1 12S " . 55 . 55 12 SURFACE#3e00C 65 . 00 i 35 . 75 TN I p 1 to 3 3 t F f � r L k L" i � t i 1 °h Sal-es,--- ax-,L reight- Mkssc CD"-. Deposit - ash C D TOTAL 35 . 75 A FINANCE CHARGE OF 11/2% PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF ec I e 10151 Hague Road ATF 1 .1°,122 , �e r, 'm �o► Indianapolis, Indiana 46256 M t, :p" _ (317)849-9666 p 14- fll��l�� ` .,Ifflf-,. www.hardingasphalt.com ** INVOICE ** BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ( 317 ) 733-2001 Tax Juris : 0001 INDIANA ATTN BONNIE St Ord Date .�Shp-..Dat.e.w..-Ship-- Via-- Sub-Acct Cuist Ord- # -1-sman `C 1k ' Terms C Pa 01 .11 2 . 0 NET ' 15T11 1:1 Uiui Item # Ordered Shaped D e s -: r i: t 1 0 n `-Un-it Prc' Ext INVOICE INVOICE: i INVOICE �INVOICE 293950 } 12S . 55 :" . 55 12 SURFACE#300C 65 . 00 35 75 TN cX �P I � o } e a 1 ` ee ' 3 E � 7 y i (F �a W R 3 3 }ti Sales _ . -.Tax--Freight- Mise CD Deposit ash D" TOTAL 35 . 75 A FINANCE CHARGE OF 11/2%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMIT TO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF 10151 Hague Road DATE •1 1 em � "t � a Indianapolis, Indiana 46256 ern+"" k (317)849-9666 N 1(Lr(!!�`i ''�11jr�,'. www.hardin as halt.com 010E'- 112043 g p ** INVOICE ** BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA St -Ord-Date ,Shp--Date € _ Ship- Via Sub Ac'c't Cust Ord # S-lsman-"Clk-`— _ Terms- " Cppa INVOICE INVOICEINVOI�CE � ' ,INVOICE Prc� Extr Item #-.-- - - Ordered Shi 1212'e di. D e s o �n U c r 1° t i ni i CE 294024 12S ? . 81 . 81 1Z" URFA�CE#300C 65 . 00 j 52 . 65 TN p j �i y k {! f E e " Nl fps 1 I ] 1 0 i - - -Sales-1- - Tax Fre-ic ht Misc CD De osit -Cash "CD TOTAL 52 . 65 A FINANCE CHARGE OF 1112%PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS.CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF 10151 Hague Road F : LLL2 h SAJ P Indiana olis, Indiana 46256 TM r, (317)849-9666 www.hardingasphalt.com ** INVOICE ** BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA St Ord. Date,_Shp.-Date=''--Sh-ip-Via SuTb- Acct Cust Ord # hsma"n Clk �- Terms - ' CDPCI Item #. - --- - - - Ordered e, S,hipbed D e s c r im t; i ,a4-,m !-Unit- Prc' �--- ExtT - - INVOICE gINVOICE' INUOI�CE INVOICE ; ; X294.087 12S 54 I . 51 12 °SURFACE#3O.00 m 65 . 00 33 15 TN I E I 1 { 1 ; V � a Nge Sales ------T a-x--,�=F-reight Misc CD D'e'posit - -C-ash" CD - TOTAL " 33 . 15 33". 15 A FINANCE CHARGE OF 11/2% PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF � 10151 Hague Road 1=1< I p � j �� Indianapolis, Indiana 46256 - M e`� (317)849-9666 j B T� i\j��llj�:ll '��, eljilt. www.hardingasphalt.com �� ** INVOICE ** BILL TO: CAR210 SHIP TO: 000 CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT 3400 W. 131ST ST. 3400 W. 131ST ST. CARMEL, IN 46074 CARMEL, IN 46074 ATTN BONNIE ( 317 ) 733-2001 Tax Juris : 0001 INDIANA St Ord_ Date -Shp-Date:a--Ship- Via Su- Acct Cust-Ord # "' lsman` Clk�' Terms C Pc� Item Ordered , Shioped D e st ,c r i- r) i o n t-L'n t Pr61-- r- Ext INVOICE E INVOICE t INVOICE IINVOICE � E 294.136 12S 51 i . 51 X12 SURFACE#3,-Q0C 65 . 00 33 . 15 TN E P I ,e $: a of a ,n F , i 3 1 I i - I a # �v I . ¢ t 4 ! f r mesa Sales m .,,_ ---Tax _..Frei ht ___ Misc CD De osit .Cash---C D TOTAL 33 . 15 A FINANCE CHARGE OF 1112% PER MONTH PERIODIC RATE,WHICH IS AN ANNUAL RATE OF 18%WILL BE INCURRED ON ALL PAST DUE AMOUNTS. CUSTOMER SHALL BE LIABLE PLEASE REMITTO: 10151 HAGUE ROAD FOR ALL COSTS OF COLLECTION AND ATTORNEY FEES INCURRED BY HARDING CO., INDIANAPOLIS,INDIANA 46256 INC.TO ENFORCE THE TERMS OF COLLECTION. LASER BUSINESS FORMS,INC.(317)915-5000 1-8.5-27 FORM NO.BIN 025SF VOUCHER NO. WARRANT NO. ALLOWED 20 F. E. Harding Asphalt IN SUM OF $ 10151 Hague Road Indianapolis, IN 46256 $1,073.05 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I I 42-363.001 $1,073.05 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 a F i ay, mber 13, 2013 Street Commls4oner CtroAt rnmmiccinnPr 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)) 12/13/13 $1,073.05 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