241764 02/03/15 CITY OF CARMEL, INDIANA VENDOR: 00351017
ONE CIVIC SQUARE KIRBY RISK CORPORATION CHECK AMOUNT: V****1,424.62*
as CARMEL, INDIANA 46032 27561 NETWORK PLACE CHECK NUMBER: 241764
CHICAGO IL 60673-1275 CHECK DATE: 02/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
652 5023990 107807131 1,424.62 S107807131.001
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DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
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CUSTOMER NUMBERT CUSTOMER •• NUMBER RELEASE NUMBER TERMS
74918 S14668 PT 10TH PROX NET 30TH
SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE
KEVIN R FORD DIRECT DUANE.JARVIS FISHERS 317-598-6170 01/05/15
ORDERQTYJ SHIPQTY I DESCRIPTION ITEM PRICE UNIT EXT AMOUNT CASH DISC
lea lea ABB OT200003C 1326.02 lea 1326.02
ABB DISCONNECT N-F 125A-800A
KRPNM
"*SUBJECT TO VENDOR RETURN POLICY"
lea lea ABB OHB80J6 65.91 lea 65.91
BLACK PISTOL HANDLE
KRPNM
"SUBJECT TO VENDOR RETURN POLICY"
lea lea ABB OXP6X290 14.65 lea 14.65
SHAFT
KRPNM
"*SUBJECT TO VENDOR RETURN POLICY"
Billing Questions:Billing_request@kirbyrisk.com(765)446-3054 Invoice Number S107807131.001
Subtotal 1406.58
S&H Charges 18:04
Invoice is due by 02/28/15. Sales Tax 0.00
ITI Lei 11= 1424.62
0001:0001 Kirby Risk Page 1 of 1
TER_VIS AND CONONS OF SALE
Af.'Cf-PT.A.NI(,'I-.,,ogu,rfu (".001M PUfps.14ASED ONTHIS INVOIC ' CONSrilir. ES AND
ACCETTANICE OVIIIE TERMS ANK)C'UNRITIONS(3,1"SALE,WHICH FOLLOVY.
(1) ,e rewriled.Without a s1,6ppini, ticket
Sto& KI
MCC[iflUdiSe iS SLI-Illoct to"i 7eturrl che
uu � No goods�m�ay1)
and'orr
- ;voice mumbor and prior authorizatIOD.
(2) Non-Sto&MIerdiandise is uot returnable unless wc can secure c,"RetuTacd `Go()(Ls Authority"IrOTY,
the Vendor.
(3) I'hc Custornerack.-no,,vledgel,Wld W-IrCCS,,thwlii all.purcjh.j-cs ofgotd..- and services fton.l seller,Selter
lit.)exj)ress warramies,or implied warraniies F11,11OSS r,111V IeL ll,al
(4) be Custorna
ergrees Chat Seller wan
ill not be liable for y incidelitid d"I'MIaUcs Llrislffi)
I I ron"I Ilny ca-use associated.with.dh.e g0ods purchased Froul Seller,
(5) Taxeq Pmce,,shown do nol include sale",or othertaxes ilrq)used on the sale ofgPods, Tl,ixe.,110)AV 01'
--will.be uddcd io-thc,purchase pricc, Buycragrccs Ici
licrcaltcr iawoscd upwi sedics or shipircryts
reimburse Seiler for,.my such tax or 1)rovi& Sellor with accepwble tax emomption cerilflcnte.
(6) Delay in DeH-Very 4eller is not to be accouatable for dclays in ddi-very, occasioned bv ac!r of God or
othei,circunisan nees over w 11 ich Set ler has no direct Com ro 1. Vactory shipinerli or del ivOry date, are the
best estilylates ofour.suppliers.,and 41,TIC)Case shall Seiler Ix,fiabic t0r auy consequenticil fir",PCchat
From anv delay in deliverv,
(7) Waiver-- The:['blurt of,scj.R;r to insist upon the parformance ofany of the temnof conditioi.is(ilfuld's
contract or to oxere-ise nn,-y riidit herounder sliall not be deemed to bea waiver ol'miclh temn,",
conditions or right irl the rualre.nor shall It bc deemed to be a WMIJVel-011FUTI '06WE tel-M,COI.Idid)D.j or
Tight "under this,cont-meL
.(3) Modification ofTerrus and Conditions
floam,cemcil! or 1111do'-slandino.in ally way purporting to rnodifv tksc terim,or conditions, shall be
bindill'y oll Seller Without Seller's written COUS&I'lt,
VOUCHER # 146595 WARRANT # ALLOWED
351017
+! IN SUM OF $
KIRBY RISK ELECTRICAL SUPPLY
oaOX 6g 9-715.1,1
IN$IAN AP-OL4S;I PJ-4 6266----,
L (0o03—���5
Carmel Wastewater Utility j
ON ACCOUNT OF APPROPRIATION FOR
;I
Board members
i
PO# INV# ACCT# AMOUNT Audit Trail Code
�I
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'I
S107807131.tob2-2308-00 $1,424.62
Depreciation iff
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Voucher Total $1,424.62 y`
Cost distribution ledger classification if !f
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
351017
KIRBY RISK ELECTRICAL SUPPLY I Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 1/28/2015
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
1/28/2015 S107807131. $1,424.62
i
I
i
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
Date Officer