233889 06/18/14 F. CITY OF CARMEL, INDIANA VENDOR: 316200
ONE CIVIC SQUARE UTILITY SUPPLY CO INC.�- CHECK AMOUNT: $ 660.03
:�� j'+� CARMEL, INDIANA 46032 6310 S HARDING ST CHECK NUMBER: 233889
b,��eN� INDIANAPOLIS IN 46217 CHECK DATE: 06/18/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1123896 660.03 OTHER EXPENSES
INVOICE
UTILITY SUPPLY COMPANY
Branch: 01 USC INDY INVOICE
6310 SOUTH HARDING STREET 1123896
(0'
INDIANAPOLIS,IN 46217 Invoice Date Page
US 5/29/2014 14:41:57 1 of I
ORDER NUMBER
317-783-4196 1132373
Bill To: Ship To:
CARMEL WATER DISTRIBUTION CARMEL WATER DISTRIBUTION
3450 WEST 131ST STREET 3450 WEST 131ST STREET
CARMEL,IN 46074 CARMEL,IN 46074
US US
Attn:K LOVEALL Ordered By:Mr.MATT MCNULTY
Customer ID: 100753
PO Number Term Description Net Due Date Disc Due Date Discount Amount
MCNULTY Net 30 DAYS 6/28/2014 6/28/2014 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
5/29/2014 11:10:41 1135422 ANDY NUGENT AMPELHAM
Quantities Pricing
Item ID UOM Unit Extended
UOMa Item Description Price Price
Ordered Shipped Remaining Unit Size q Unit Size
Carrier: CUSTOMER PICK UP Tracking#:
1.00 1.00 0.00 EA 226-127520-000 EA 660.0300 660.03
1.0 12 X 20 SMITH BLAIR 1262-1302 1.0000
REPAIR CLAMP
Total Lines: 1 SUB-TOTAL: 660.03
TAX: 0.00
A FINANCE CHARGE computed at a periodic rate of 1 112%per month(18% AMOUNT DUE: 660.03
ANNUAL PERCENTAGE RATE)is applied to PAST DUE ACCOUNTS OVER 30 DAYS.
ORIGINAL
VOUCHER # 135316 WARRANT# ALLOWED
316200 IN SUM OF $
Utility Supply Company
6310 South Harding Street
Indianapolis, IN 46217
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
'I
PO# INV# ACCT# AMOUNT Audit Trail Code
1123896 01-6200-06 $660.03
y
s
I
Voucher Total $660.03
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
316200
Utility Supply Company Purchase Order No.
6310 South Harding Street Terms
Indianapolis, IN 46217 Due Date 6/9/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/9/2014 1123896 $660.03
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
Date Officer