238636 10/28/14 �! �,• CITY OF CARMEL, INDIANA VENDOR: 172430
ONE CIVIC SQUARE KAYLINE COMPANY CHECK AMOUNT: $*******179.63*
;� ,_� CARMEL, INDIANA 46032 PO BOX 603207 CHECK NUMBER: 238636
+�'�TON�° CLEVELAND OH 44103 CHECK DATE: 10/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 216283 179.63 OTHER MAINT SUPPLIES
j
f
-�% LINER ORIGINAL INVOICE � AME6ICAN
visAr ��ESs
Profeseionel Maintenance Products PLEASE REMIT FROM THIS INVOICEI SSAMEMBER
. .'..'.
On C"",39
7'—'a
'-'a
B ATTN: ACCOUNTS PAYABLE H ATTN: JIM BENTLEY
L CARMEL STREET DEPT ' H CARMEL STREET DEPT
3400 W. 131ST ST. I 3400 W. 131 ST ST.�
L WESTFIELD, IN 46074 P WESTFIELD, IN 46074
T T
O O
INVOICE NO. ORDER DATE CUSTOMER P.O. VENDOR NO PAGE INVOICE DATE
216283 10/16/14 JIM BENTLEY 1 10/16/14
CUSTOMER NO. SALESMAN TERMS SHIP VIA F.O.B. Warehouse:
10750-S HERMANN 1% 10 DAYS NET 30 U.P.S. WHSE 3303 LakesOh
I Cleveland,3303Ohio 4444114
r
PRODUCT NUMBER DESCRIPTION UNIT
OF UNITS NET UNIT EXTENDED
MEASURE ORDERED' SHIPPED PRICE AMOUNT
I'
K224 AQUA SCRUB/CENTENNIAL CS i 1 159.990 159.99
Kayline Light Bulbs
The"Light"Way To Savel
iI
't
U BTOTAL 159.99.
• Kayline Fed.I.D.No.34-0325350 REMIT TO: KAYLINE COMPANY rAX 0.00
1 1/2%Charge per month past 30 days. P.O. BOX 603207 REIGHT 19.64
• All freight claims must be filed by customer. I
No goods returnable without Kayline's written consent CLEVELAND, OH 44103
• Do not take discounts on sales tax or freight charges. OFFICE: (216)566-9858*(800)426-5820PAY
www.kaylinecompany.com 1 THIS
FAX: (216)566-1228 AMOUNT 179.63
i
VOUCHER NO. WARRANT NO.
Kayline Company ALLOWED 20
IN SUM OF$
P. O. Box 603207
Cleveland, OH 44103
$179.63
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 216283 42-389.00I $179.63 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
12014
Street Commissioner7
Title
i
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
ClWi 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))
10/16/14 216283 $179.63
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