HomeMy WebLinkAbout235854 08/13/14 CITY OF CARMEL, INDIANA VENDOR: 114000
CHECK AMOUNT: $*******831.73*
.s �• ONE CIVIC SQUARE GRAYBAR ELECTRIC CO, INC
CARMEL, INDIANA 46032 12431 COLLECTIONS CENTER DRIVE CHECK NUMBER: 235854
CHICAGO IL 60693 CHECK DATE: 08/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4237000 32398 973941202 390.03 CAT PORT PATCH
1115 4238000 32402 974018752 441.70 FLUKE KIT
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Remit To: (� 12431 COLLECTIONS CENTER DRIVE ~: �->�-,.i=, -=''` ^`` ` "'A�" "
CHICAGO IL 60693-2431 317-821-5700 or ARQuestions cr graybar.com
INVOICE Invoice No: 973941202
MB 01 000671 54942 B 3 C Invoice Date: 07/29/2014
Account Number: 0000154108
CARMEL CLAY COMM CENTER Account Name: CARMEL CLAY COMM
JANET ARNONE CENTER
31 FIRST AVE N.W.
CARMEL,IN 46032-1715
Ship to: CARMEL CLAY COMM CENTER
CARMEL CLAY COMMUNICATION
31 FIRST AVE N.W.
CARMEL IN 46032-1715
- - -- - - - - -- -------- Page 1 of 1
Order No:CCCC SO#:348075156
Del.Doc.#: I PRO# Routing Date Shipped Shipped From F.O.B. Rt.To
0862547607 llZ441068037,9698004 UPS 07/29/2014 1 INDIANAPOLIS,IN S/P-F/A ='=
Quantity Catalog#/Description Unit Price / Unit Amount
1 69586-U24 LEVITON MANUFACTURING.COMPANY,INC 183.53 / 1 183.53 A'a
CAT 6 24 PORT PATCH PANEL
10 M21-750-595-WT BRADY WORLDWIDE INCORPORATED 20.65 /A 206.50
CART BMP 21 B595 3/4X21 BLK/WHT
Terms of Payment Sub Total 390.03
Freight 0.00
Net 30 Days Handling 0.00
As a condition of the sales agreement,a monthly service charge of the lesser of Tax 0.00
1-1/2%or the maximum permitted by law may be added to all accounts not paid Total Due 390.03
by net due date.Visa,MasterCard,American Express,and Discover credit cards o
are accepted at point of purchase only.
Subject to standard terms and conditions on the reverse side.
GRAYBAR ELECTRIC COMPANY,INC.
TERMS AND CONDITIONS OF SALE
1. ACCEPTANCE OF ORDER;TERMINATION-_Acceptance of:any order is subject to credit approval and:acceptance of order by Graybar Electric
Gorrrpany;:lrie:('GrayE3ai J :nd,.yrheh applicable;Graybar's suppliers.If credit of the buyer of the goods("Buyer")becomes unsatisfactory to Graybar,
Graybar reserves the right to terminate upon notice to Buyer and without liability to Graybar:
2. PRICES AND SHIPMENTS-Unless otherwise quoted,prices shall be those in effect at time of shipment,which shall be made F,O.B.shipping point,
prepaid and bili.
3. RETURN OF GOODS Credit may be allowed for goods returned with prior approval.A deduction may be made from credits issued to cover cost of
handling,
4. TAXES-Prices shown do not include sales or other taxes imposed on the sale of goods:Taxes now or hereafter irnposed:upon sales ar shipments will
be added to the purchase price.Buyer agrees to.reimburse Graybar for any stich tax or provide Graybar with acceptable fax exemption certificate.
5.. DELAY iN DELIVERY_Graybar:is not to:be accountable for delays in delivery occasioned by.acts of God,failure of its suppliers to ship or deliver
on:time;or other.circumstances beyond Graybar's reasonable control.Factory shipment or delivery dates are the,best estimates of our suppliers,
and in no case shall Graybar be liable for any consequential or special damages arising from any delay in shipment or delivery.
6.. LIMITED WARRANTIES _ Graybar warrants that all goods sold are free of any security interest and will make available to Buyer all transferable:
warranties(including without limitation warranties with respeetto intellectual property infringement)made to Graybar by the manufacturer of the goods:
GRAYBAR MAKES NO OTHER:EXPRESS OR IMPLIED WARRANTIES,AND SPECIFICALLY DISCLAIMS ALL IMPLiED WARRANTIES INCLUDING.
BUT NOT LIMITE=D TO THE MWLIED WARRANTIES OF MERCHANTABILITY AND FITNESS.FOR.PURPOSE_UNLESS OTHERWISE AGREED
IN ARiTING BY AN AUTHORIZED REPRESENTATIVE-OF GRAY_BAR,PRODUCTS SOLD HEREUNDER.-ARE NOT INTENDED FOR USEAN-OR-
IN CONNECTION WITH (I)ANY SAFETY APPLICATION OR THE CONTAINMENT AREA OF A NUCLEAR FACILITY OR(2) IN A HEALTHCARE
APPLICATION,MERE.THE GOODS HAVE POTENTIAL.FOR DIRECT PATIENT CONTACT OR'AtHERE A SIX(6)FOOT CLEARANCE.FROM A
PATIENT CANNOT BE MAINTAINED ATALL TIMES..
7. LIMITATION OF LIABILITY-Buyer's remedies under this agreement are subject to any limitations contained in manufacturer's terms and conditions
'to Graibar,a copy of which will be furnished upon written request.Furthermore,Graybar's liability:shall be limited to either repair or replacerrient of
the goods or refund of the purchase price,all at Graybaesz option,and IN NO CASE SHALL! GRAYBAR BE LIABLE FOR INCIDENTAL;SPECIAL,OR
CONSEQUENTIAL DAMAGES.In addition,claims for shortages,other than loss in transit,must be made in writing not more than five(5)days after
receipt of shipment.
8. WAIVER-The failure of Graybar.to insist.upon the-performance-of any of the terms or conditions of this agreement or to exercise any right hereunder
shall not be deemed to be a waiver of such terms,conditions,or rights in the future,nor shalt it be deenied to be a waiver of any other term,condition:,
or:right:under this agreement.
9. MODIFICATION OF TERMS AND.CONDITIONS-These terms and conditions supersede ail other communications;negotiations,and prior-oral
or writtein statements:regarding the subject matter of these terms and conditions.No change,modification,rescission, discharge,abandonment,
or:avaiver of these terms and conditions.shall be:binding upon Graybar unless made in writing and signed.on its:behalf by a duly authorized represen-
tative of Graybar,No conditions,usage:of trade,course.of dealing or performance,understanding .or agreement,purporting to modify,vary,explain,
or supplement these terms and conditions shall be binding unless hereafter made in writing and signed by the party to be bound.Any proposed
modifications or additional terms are specifically rejected and deemed a material.alteration hereof.If this document shall be deemed an:acceptance.
of a prior offer by Buyer,such acceptance is expressly conditional upon Buyer's asseni.to any additional or different terms set forth herein.
10. REELS-When Graybar ships returnable reels,a:reel deposit may be included in the invoice.The Buyer should contact the nearest Graybar service
location to return reels.
11. CERTIFICATION-Graybar hereby certifies that these goods were produced in compliance with all applicable requirements of Sections 6,7,and 12 of
the Fair Labor Standards Act,as amended;and of regulations and orders of the United States Department of labor issued under_Sectla.n 14 thereof.
--Thl"greement is subject to Exectitive_Ofder 11241..5;ai amended,the Rehabilitation Act of 197x,as amended,the Vietnam.Veterans'Readjustment.
Assistance Act of 1974,as amended,E.O,1341015,20 CFR Part 471,Appendix.A.to Subpart A,and the corresponding regulations,to the extent:reryuired
bylaw.41 CFR 60-1..4,60-741.5;and 60-250.5 are incorporated herein by reference,to the extent legally required.
12. FOREIGN CORRUPT PRACTICES ACT Buyer shall onmplywith applicable lawsand regulations relating to anti-corruption,including,without limita-
tion,(i)the United States Foreign.Corrupt Practices Act(FCPA)(15 U..S.C.§§78dd-1,et.seq_)irrespective.of the place of-performance,and(ii)laws
and regulations implementing.the Organization for Economic Cooperation and Development's Convention:on Combating Bribery of Foreign Public
Officials in international Business Transactions, the U.N..Convention Against Corruption,acid the Inter-American Convention Against Corruption:in.
Buyer's country or any country where performance of this.agreement or delivery of goods will occur.
13. ASSIGNMENT-Buyer shall not assign its rights or delegate its duties hereunder orany interest herein without the prior written consent of Graybar,
and any such assignment,evithoUt such consent;shall be void'.
14. GENERAL PROVISIONS—All typographical or clerical errors made by Graybar in any quotation,acknowledgment or,publication are subject to
correction.This agreement shall be governed by the laws of the State of Missouri applicable to contracts to be formed and fully perforimed within the
State:of Missouri,without giving.effect to the choice or conflicts of Iaw provisions thereof.All suits arising from or concerning this agreement shall
be filed in the Circuit Court of St.Louis County,Missouri,or the United States District Court for the Eastern District of Missouri,and no other place
unless otherwise determined in Graybar's sole discretion.Buyer hereby irrevocably consents to the jurisdiction of such court of-courts and agrees Y.
to appear in any such action upon written notice thereof.. 14:i
15. EXPORTING-Buyer acknowledges that this order and the performance thereof are subject to compliance With any and all applicable United States
laws, regulations,or orders. Buyer agrees to comply with all such lauds, regulations,and orders,.Including, if applicable,all requirements of the
international Traffic in Arms Regulations andlor the Export Administration Act,as may be amended.Buyer further agrees that if the export.laws are �
applicable,it Wiil not disclose or re=export any technical data received under this order to any countries for which the United States government
requires an.export license or othersupporting documentation at-the time of export or transfer,unless Buyer has obtained prior Written authorization s
from the United States Office of Export Control or other authority,responsible for such mutters. S
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 32396
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
7129/2014
Grayhar Electric Carmel Communication Center
VENDOR SHIP 31 1 st Ave NW
TO
12431 Collections Center Drive Carmel, IN 46032
Chicago, IL 60693 (317)571-2576
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-371.00
1 Each CAT 6 24 port patch panel 69586-U24 $183.53 $183.53
10 Each CART BMP 21 M21-750-595-WT $20.65 $206.50
- Sub Total: $390.03
'
'43
Send Invoice To:
Carmel Communication Center - -
31 1 st Ave NW
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECTACCOUNT AMOUNT
1115 Communications PAYMENT $390.03
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ! /
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. '
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 23# 9 8 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
i
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I 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
I
20
Signature
Title
Cost distribution ledger classification if I
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Graybar Electric
IN SUM OF $
12431 Collections Center Drive
Chicago, IL 60693
$390.03
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
32398 I 973941202 I 42-370.00 I $390.03 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
Wednesday, August 06, 2014
Director
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.
r
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/29/14 I 973941202 I I $390.03
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
, 20
Clerk-Treasurer
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Remit To: 12431 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693-2431 317-821-5700 or ARQuestions(a?graybaccom
GrEWWL INVOICE Invoice No: 974018752
Invoice Date: 08/01/2014
MB 01 000627 57175 E 3 A
II���1��1111�"I.II�111�11'll'11"�I��II111111'1'll�l'�I11��1�111 Account Number: 0000154108
CARMEL CLAY COMM CENTER Account Name: CARMEL CLAY COMM
JANET ARNONE CENTER
31 FIRST AVE N-W.
CARMEL IN 46032-1715
Ship to: CARMEL CLAY COMM CENTER
CARMEL CLAY COMMUNICATION
31 FIRST AVE N.W.
CARMEL IN 46032-1715
- —-- — ------ -- - --- - - - - _ --- --_—Page i-of 1---
Order No:32402 SO#:348133121
Del.Doc.#: PRO# Routing Date Shipped Shipped From FO.B. Rt.To
0862624249 iZE9Wo21o3sso53372 UPS 08/01/2014 ZONE-JOLIET,IL
Quantity Catalog#/Description Unit Price / Unit Amount
1 FLUKE-87-5/E2 KIT FLUKE ELECTRONICS CORP_ 441.70 / 1 441-70
INDUSTRIAL TRUE-RMS MULTIMETER COMBO KIT
Terms of Payment Sub Total 441.70
Freight 0.00
Net 30 Days Handling 0.00
As a condition of the sales agreement,a monthly service charge of the lesser of Tax 0.00
1-1/2%or the maximum permitted by law may be added to all accounts not paid Total Due 441.70
by net due date.Visa,MasterCard,American Express,and Discover credit cards
are accepted at point of purchase only.
0
0
0
0
ail
Subject to standard terms and conditions on the reverse side.
GRAYEAR ELECTRIC COMPANY,INC.
TERMS AND CONRIMNS OF SALE
I ACCEPTANCE OF ORDER;TERMINATION-Acceptance of any order is subject to credit approval and acceptance of ceder by Graybar Electric
Company;:Inc:("GtayiJa .}and,W en applicable,Graybar's suppliers. t _ 4 . � % 'r")betbr' it t1siactbr it,
.. .O.pli rs.11'credii ofthebUydrofthegoodtl"Buye
Graybar*reserves thedontto terminate upon notice to Buyer an.d.without liability to Graybar:. ric.,unta...... y to Grayb,
2. PRICES AND SHIPMENTS-UNess otherwise quoted,prices shall be those in effect at time of shipment,which shall be made F.O.B.shipping point,
prepaid and bill.
3. RETURN OF GOODS-Credit may be allowed for goods returned with prior approval.A deduction May be made from credits issued to cover cost of
handling.
4. TAXES-Prices shown do not include sales or other taxes imposed on the sale of goods:Taxes now or hereafter imposed upon sales or shipments Will
be added to the p6rchase price.Buyeragrees to reimburse Graybar for any such tax or provide Graybar With acceptable tax exemption certificate.
5_ DELAY IN DELIVERY"Graybaris not to:be accountable for delays in delivery occasioned by-acts of God,failure of its suppliers to ship or deliver
ort time,or other circumstances beyond Graybar's reasonable control.Factory shipment or delivery dates are the best estimates of our suppliers,
and in no case shall Graybar b6.fiable for any consequential or special damages arising from any delay in shipment or delivery.
6.. LIMITED WARRANTIES_Graybar warrants that.all goods sold are free of any security interest and will make available
able to Buyer all transferable.
warranties(including without limitation warranties With respectto intellectual property infringement}. :mada to Graybar by the manufacturer of the goods:
GRAY BAR MAKES NO OTHER EXPRESS OR IMPLIED WARRANTIES,AND SPECIFICALLY DISCLAIMS ALL IMPLIED WARRANTIES INCLUDING
BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS.FOP.PURPOSE.UNLESS OTHEkW(SE AOPE5D
IN WRITIN(�BY AN AUTHORIZED REPRESENTATIVE OF GRAYbAR,PRODUCTS SOLD HEREUNDER ARE NOT INTENDED FOR USE.IN OR
IN CONNECTION WITH(1)ANY SAFETY APPLICATION OR THE-CbNTAINMENT AREA OF A NUCLEAR FACILFITY,OR_C2)IN.A HEALTHCARE EALTHCARE
CONTACT OR R�_ �_ ri
APPLICATION,WRERE.THEGOODS HAVE P&ENTIAL.FOR DIRECT PATIENT CO %Jc,1H_E A SIX(6) F6OT7GCEA_RAF4_r_E-N 6-1 A
RATIENT CANNOT BE MAINTAINEoATALLTIMES..
7. LIMITATION OF LIABILITY'-Buyers fernedies Linder this agreementare subject to aetylimitafibris contained in mahufactUter's terms and c6hdiflorts
'to Graybar,a copy.of which will be-furnished upon written request.Furthermore,Graybarlt,liability shall be limited to either regale or replacement of
the goods or refund of the purchase-price,all at Graybar's option,anti:IRI NO CASE SHALLGRAYBAR BE LIABLE FOR INCIDENTAL,SPECIAL;OR
CONSEQUENTIAL DAMAGES.In addition,claims for shortages,othetthan lost in transit,must be made in writing not hibre,than five(%days after
receipt of shipment.
8.. WAIVER-The failure of Graybar.to insist,upon the-performance-of any of the terms or conditions ofthis-agreerneni or to exercise any righthereunder
shall not bedeemed to be a Waiver of such terms,conditions,or fights in the future-,nor shall:it be deemed to be a Waiver of any other term;condition-,
or daht.under this agreement.
9.. MODIFICATION OF TERMS AND CONDITIONS-these terms and conditions supersede all.other*communications,negotiations,- . and prior-oral.
or written statements:regarding the subject Matter of these terms and conditions.No change,rriodifi(jatloh,rescission,discharge,abandonment,
orwaiver of these terms and conditions.shall be.binding upon Graybar unless made In writing and signed.on its.behalf by a duly authorized represen=
tative of Graybar.No conditions,usage of trade,course of dealing or performance,understanding.or agreement,.purporting to modify,vary,explain,
or supplement these terms and conditions shall be binding uriless hereafter made in writing and signed by the patty to be bound.Any proposed
modifications or additional terms are specifically rejected and deemed a material.alteration hereof.If this document shall be deemed artacceptance.
of a prior offer by Buyer,such acceptance is expressly conditional upon Buyer's assentio any additional ordiff'erent terms set forth herein.
10. REELS-When Graybar ships returnable reels,areel deposit may be included in the invoice.The Buyer should contact the nearest Graybar service
location to return reels.
11. CERTIFICATION-Graybar hereby certifies that these goods were produced in compliance with alf applicable requirements of Sections 0,7,and 12 of
the.Fair Labor Standards Act,as amended,and of regulations and orders of the United States Department ofLabor issued under Section 14 thereof..
This agreement is subject to Executive Order 11246;:as amended,the Rehabilitation Act of 157-3,as amended,the,Vietnam Veterans'Readjustment
Assistance Act of 1974,as amended,E-0,1345,25 CPR Part 471,Appendix.Ato Subpart A,and the corresponding reguiat.ions,'to the extentrequired
by law..41 CFR 60-1-4,60-741.5i and 60-250.5 areincorporated herein,by reference,to the extent legally required.
1.2. FOREIGN CORRU PT PRACTICES ACT--Buy.er shall-comply with_gppricable laws and regulatipris relating-to anti-corruption,including,v4thpt -limits--
tion. - - it
o6,�i)the United States Fbrei"-rf-ffo-iiupt�P--r,-actice-s-A'ct(-F-CPA)(15 U.S.C.3r,78dd-1,et.seq-)irrespective of the place ofperformance,and(ii)laws
and regulations implementing.the Organization for Economic Cooperation and Development's Convention:on Combating. Bribery of Foreign.Public
Officials in International.Business Transactions,the U.N..Convention Against Corruption,and the Inter-American Convention Against'Corruption,in
Buyer's country or any country where performance of thisagreement or delivery of goods wilt occur.
13. ASSIGNMENT-Buyer shall not assign its rights or delegate its duties hereunder or any interest herein without the prior written consent of Graybar,
and any such a$sigriMe.rit,withobt such consent,shalt be void.
14. GENERAL PROVISIONS—All typographical or clerical errors made by Graybar in any qLiotationi acknowledgment or publication are subject to
correction,This agreement shall be governed by the laws of the State of Missouri applicable to contracts to be fofted and fully peffbeined within the
State:of Missouri,Without giving,effect to the choice or conflicts of lalffprovisions'thereof.All suits arising from oetortweiing this agreement shall
be filed in the Circuit Court of St.Louis County,f0issouri,or the United States District Court for the Eastern District of Missouri,and no other place
unless otherwise deterinined in Graybat's tole discretion.Buyer hereby irrevocably contents to the jurisdiction of such court or courts and agrees
to appear in any Such open action un Written notice thereof-
r1U
1.5- EXPORTING-Buyer acknowledges that this order and:the performance thereof are subject to compliance With any and all applicable United States
laws; regulations,.or orders. Buyer agrees to comply with all such laWs, regulations,and orders,.including, if applicable, all requirements of the
International Traffic in Arms Regulations and/or the ExportAdministration Act,as may be amended:Buyer further agrees that if the export laws are 0
applicable,it Will not disclose or re-export any technical data received:'under this order to any countries for Which the United States government cri
requires an.export license or otherzLipporting docurfientation at the time of export or transfer.unless Buyer has obtained prior Written authorization <
from the United States Office of Export Control or Other authority responsible for such matters_ M
VOUCHER NO. WARRANT NO.
I
i
Graybar Electric ALLOWED 20
IN SUM OF$
12431 Collections Center Drive
Chicago, IL 60693
$441.70
i
ON ACCOUNT OF APPROPRIATION FOR
i
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32402 I 974018752 I 42-380.00 I $441.70 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
I
Friday ugust 0 , 014
4 1 61g
Direc r
Title
Cost distribution ledger classification if
claimaid motor vehicle highway fund
Y
P 9 i
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))
08/01/14 974018752 $441.70
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