242896 03/11/15 {�'.��qa, CITY OF CARMEL, INDIANA VENDOR: 358688
"` ' . CHECK AMOUNT: $*******322.50*
.;; ® ONE CIVIC SQUARE AGRO CHEM
_� CARMEL, INDIANA 46032 2045 S WABASH STREET CHECK NUMBER: 242896
9'"roN2a� . WABASH IN 46992 CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 0031379-IN 322.50 REPAIR PARTS
Page: 1
Invoice
Agro-Chem, Inc.
AGRO-CHEM 2045 S. Wabash St. Invoice Number: 0031379-IN
® Wabash, IN 46992 Invoice Date: 2/27/2015
(260)563-0672
www.agrochem.com
Sales Rep: 0002
Customer Number: 0002763
Sold To: Ship To:
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 WEST 131ST STREET 3400 WEST 131ST STREET
WESTFIELD, IN 46074 WESTFIELD, IN 46074
Confirm To: STATEMENTS SENT BI-MONTHLY-PLEASE PAY FROM INVOICE
_--------- _- — — -- - Email-Inquiries:__kareni rmith@agrochern.corn__
Customer P.O. Ship VIA Terms Due Date
NET 30 DAYS 3/29/2015
Ordered Shipped Bk Ordered Item Code Description Price Each Amount
1 1 0 16637 200 GAL PCO 322.50 322.50
Net Invoice: 322.50
Less Discount: 0.00
Freight: 0.00
Sales Tax: 0.00
Invoice Total: 322.50
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VOUCHER NO. WARRANT NO.
ALLOWED 20 ,
Agro Chem Inc
IN SUM OF$
2045 S. Wabash Street
Wabash, IN 46992
' I
$322.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 0031379-IN j 42-370.00 $322.50 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
)n rid 015
SS �t3ifiit�$�61abr
Title
i
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
i
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))
02/27/15 0031379-IN $322.50
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
i
20
Clerk-Treasurer