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242335 02/17/15 "F CITY OF CARMEL, INDIANA VENDOR: 00351074 ® ONE CIVIC SQUARE KIMBALL-MIDWEST CHECK AMOUNT: $******"198.95* CARMEL, INDIANA 46032 DEPT L-2780 CHECK NUMBER: 242335 COLUMBUS OH 43260-2780 CHECK DATE: 02/17/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 3994424 198.95 OTHER EXPENSES INVOICE NO.MBALL INVOICE � PLEASE PAY FROM THIS INVOICE 3994424 VfIDWEST ORIGINAL ORDER NO. LATE PAYMENT FEE! , , NTR WHICH IS AN ANNUAL Spec-ralfzin�an ASateriats lFlataagerxen.'smce 1s�33 0 7 4 613 2 E • 18% WILL BE REMIT TO: KIMBALL MIDWEST ACCOUNT NO. _ ADDED 0 DEPT. L-2780 D DAYS OLD COLUMBUS, OHIO 43260-2780 (614-219-6100) 139903 www.kimbalimidwest.com SOLD TO: SHIP TO: CITY OF CARMEL SEWER DEPT SEWER DEPARTMENT 9609 HAZEL DELL PARKWAY 30 W MAIN ST ATTN LISA INDIANAPOLIS IN 46280 CARMEL IN 46032 TRENT DATE ISALES REPRESENTATIVE1 PURCHASE ORDER NO. SHIPPED VIA& DATE 01/16/15 1COHEN, ROBER RENT U UPS GROUND 01/16/15 ORDERED SHIPPED BALANCE DESCRIPTION UNIT PRICE AMOUNT 50 50 DUE NASN345 TERMINAL 62 . 50 _ 25 25 NS93710 :: TERMINAL-­ 20 20 NAB2214 TERMINAL 32 . 20 25... 25 NB93710 TERMINAL : 34 . 75.:: 25 25 NA92110 TERMINAL34 . 75 ._.UPS _TRACKING :: 1Z47:8173034459138 WGT: 1 To help us correctly process yo r .pament please .. .. ....... y :e Tncltides invoice number on your remittance a vice . hank yo for y r :busi.nessl:, Paymentis _due 02/1 /15 - lease.M 3.rl by 02/0&/x.5 o receive invoices via email send a request inc uding you ecount umber invoice@kimballmidwest . corn: You acknowledge and agree that,by placing this order,all information provided to you by Kimball Midwest herein is confidential and is the property of Midwest Motor Supply Co.,Inc.d/b/a Kimball Midwest.You further agree that this Information is for your internal use only and will not be copied,reproduced,distributed or disclosed by you and/or your organization without the prior written consent from Kimball Midwest. CARRIERS RECEIPT IN GOOD ORDER CON- ORDERED TAX% TAX AMT. SHIPPING INVOICE TOTAL STITUTES DELIVERY AND CLAIMS FOR LOSS OR DAMAGE IN TRANSIT MUST BE FILED BY CUSTOMER. GOODS RETURNED WITHOUT OUR CONSENT WILL POSITIVELY NOT BE ACCEPTED. 198 . 95 198 . 95 DEBTOR IS LIABLE FOR USUAL AND CUSTOM- ARY COLLECTION CHARGES. ALL CHECKS MUST BE MADE PAYABLE ONLY TO"KIMBALL MIDWEST' We Appreciate Your Business PLEASE REMIT THIS AMOUNT Prescribed by State Board of Accounts Form No 301(Rev.1995) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount 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 Mo. Day Yr. Signature Title 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. Mo. Day Yr. Officer Title I Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. ACCT. NO. 3V5,)b?t/ CARMEL, INDIANA M`F vor Of CC\OV- ,1zk>5 DH Lk3')Lb-xr�j Total Amount of Voucher $ ' Deductions -399 4 -2 L (-PSD. I I Amount of Warrant $ Month of Yr Acct. VOUCHER RECORD No. Source of Supply Water Treatment Transmission and Dist. Customer Accounts Administrative and General Operation-Maintenance Utility Plant in Service Constr.Work in Progress Materials and Supplies Customers Deposits Total Allowed Board of Control Filed Official Title BOYCE FORMS.SYSTEMS 1-800-382-8702 325