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241280 01/22/15 %.c,qy\� CITY OF CARMEL, INDIANA VENDOR: 368799 ® ONE CIVIC SQUARE FLOSOURCE CHECK AMOUNT: $*******159.38* _� CARMEL, INDIANA 46032 489 GARDNER AVE CHECK NUMBER: 241280 °MjiTON p MARTINSVILLE IN 46151 CHECK DATE: 01/22/15, DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 48684 159.38 OTHER EXPENSES 36686 489 Gardner Ave Invoice MFLOSCURL& Martinsville, IN 46151 Invoice Number: VALVES I ACTUATION I INSTRUMENTATION l STEAM SPECIALTIES www.flosource.com 48684 Invoice Date: 2015 Voice: 765-342-1360 Jan 5, Page: Fax: 765-342-1361 1 E-Mail: sales@flosource.com Sold To: Ship to: Carmel Utilities/Water Operations armel Utilities/Water Operations 3450 W. 131st St. 4915 E 106th Street Carmel, IN 46074 Tag: PO# JR102814 USA Carmel, IN 46033 USA Customer ID Customer PO Payment Terms Carmel Utilities JR102814 Net 30 Days Sales Rep ID Shipping Method Ship Date Due Date Tim Colley UPS ACCT # Y22R43 2/4/15 Quantity Item Description Unit Price Extension Parts for SN 983556-10 1-2 weeks I 3.00 ETER 3-4045-18 PN 3-4045-18 Change Gear Assy, 18 23.06 69.18 3.00 ETER 3-4045-45JJ PN 3-4045-45JJ Change Gear Assy, 23.06 69.18 45JJ Damages And Short Ships Must Be Reported 5 days Or Earlier After Receipt Of Shipment. Overdue balance will accrue interest at the rate of 1-1/2% per month compounded plus ALL legal and collection fees. Subtotal 138.36 All FloSource Terms&Conditions Apply for a copy Sales Tax please visit: http://flosourcevalve.com/terms.pdf Freight 21.02 Total Invoice Amount 159.38 Check/Credit Memo No: Payment/Credit Applied TOTAL 159.38 VOUCHER # 142742 WARRANT # ALLOWED 368799 IN SUM OF $ FLOSOURCE 489 GARDNER AVE MARTINSVILLE, IN 46151 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# 'INV# ACCT# AMOUNT Audit Trail Code SII � 48684 01-6200-02 $159.38 ,I i I 1, Voucher Total $159.38 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 368799 FLOSOURCE Purchase Order No. 489 GARDNER AVE Terms MARTINSVILLE, IN 46151 Due Date 1/13/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/13/2015 48684 $159.38 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 /ks,11s" C�- ('mom PK- -Date Officer