242965 03/11/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 358710
ONE CIVIC SQUARE H D SUPPLY WATERWORKS LTD CHECKAMOUNT: $*******155.60*
CARMEL, INDIANA 46032 P 0 Box 91036 CHECK NUMBER: 242965
CHICAGO IL 60693 CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4342100 D283020 8.60 POSTAGE
1115 R4230100 32160 D283020 147.00 FIBER OPTIC FLAGS
MULUI[I yuproruunvvitnraymentrorrasterVremt inamc Youror►n upporrun►ty o .
We a, - ate your prompt payment
Date Ordered Date Shipped Customer PO No. Job Name Bill o Shipped Via Order Number
_1/20/14 2/24/15 32160 COMMUNICATION UPS
Product Code Description Quantity Quantity Back-
ordered Shipped Ordered Price Per Amount
Ord by: BRIAN
HD SUPPLY WATERWORKS PO#-6824111
'80013154345 ONE TIME SET UP FEE 1 1 27.00000 EA 27.00
BID SEQ# 220
'80013154346 4X5 ORANGE FLAG W/BLACK PRINT 3.000 1000 .12000 EA 120.00
AND 21" WIRE STEM W/ CENTERED
LETTERING READING:
CITY OF CARMEL
BURIED FIBER OPTICS
CALL 317-571-2777
BID SEQ## 240
its transaction is governed by and subject to HD Supply Waterworks standard terms Terms Subtotal
id conditions,which are incorporated herein by this reference and accepted.
>review these terms and conditions,please point your web browser to
tp://waterworks.hdsupply.com/TandC/. NET 30 147.00
Freight Delive Handlina Restock Misr Tax •
8.60 • 155.60
INDIANAPOLIS IN D283020
Branch - 430 .
1680 Expo Lane
Indianapolis IN 46214 Page: 1
00000
ity
®� C
����� INDIANA RETAIL TAX EXEMPT PAGE
CCERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 32160
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1120/2014 Fiber Optic Flags
HD Supply Waterworks, LTD Carmei Communication Cuter
VENDOR �� ��i �l a � SHIP 31 1 st Ave Nom'
TO
6u xp® L� r�g Carmel, IN 46032
Ilaa•wnatica�./LLi91.6.9, 56 4U214�E (317)571-2576
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-301.00
1000 Each City of Carmel fiber optic flags $0.12 $120.00
1 Each Onetime set up fee for fiber optic flags $27.00 $27.00
Sub Total: ` 147.00
fk
'A t
Sld ID#40204>#d
Send Invoice To: �
Carmel Communication Center
31 1 st Ave NW
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
1115 Communications PAYMENT $147.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. I
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
3 ® CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO. _
ALLOWED 20 i
IN THE SUM OF$
• I I
ON ACCOUNT OF APPROPRIATION FOR
•
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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 i
which charge is made were ordered and
received except
I -
i
i
i -
i ,
I
2U
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund i
j '
VOUCHER NO. WARRANT NO.
ALLOWED 20
HD Supply Waterworks, LTD
IN SUM OF$
P.O. Box 91036
Chicago, IL 60693
$155.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
'
1115 D283020 43-421.00 $8.60 1 hereby certify that the attached invoice(s), or
Encumbered bill(s) is (are)true and correct and that the
32160 D283020 42-301.00 $147.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 09, 2015
irectlop
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
,I
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
i
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
02/27/15 D283020 $147.00
02/27/15 D283020 $8.60
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
, 20
Clerk-Treasurer