244417 04/21/15' uI..Q•lq i
'''• - CITY OF CARMEL INDIANA VENDOR: 00353173
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ONE CIVIC V C SQ UARE A F C INTERNATIONAL INC CHECK AMOUNT: $""'"200.74'
?� CARMEL, INDIANA 46032 PO BOX 694 CHECK NUMBER: 244417
715C SW ALMOND ST CHECK DATE: 04/21/15
DEMOTTEIN 46310
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 43370 200.74 OTHER EXPENSES
AFC International Inc Invoice
Box 894
A [ 715C SW Almond St
1 M i 71 O N A�. INC DeMotte, IN 46310 Date Invoice#
3/30/2015 43370
Bill To Ship To
Carmel Waste Water Treatment Plant Carmel Waste Water Treatment Plant
Attn Accts Payable Attn Duane Jarvis/S14957
760 Third Ave SW 9609 Hazel Dell Pkwy
Suite 110 Indianapolis IN 46280
Carmel IN 46032
P:O.No:° 1E,
Terms Due Date. Rep, Ship,` Via
S14957 Net 30 4/29/2015 TGD 3/30/2015 Federal Express
Qty. ShippedCat: NO, Description Price Amou"rit
1 . 1 0 34-413-18 (90099056) 34GAL, Carbon Monoxide 166.60 166.60T
50ppm/Hydrogen Sulfide
1 Oppm/Methane 50% LEL/Oxygen
18%/N2 Calibration Gas, 34L. 24
month shelf life.
1 1 0 Hazardous Hazardous fee 28.00 28.00T
1 1 0 Shipping Shipping & Insurance Charges 6.14 6.14T
Tracking No 064519
Thank you for your order.We appreaciate your business.If you have any questions,please contact us at
1.800.952.3293 or fax 219.987.6826.Returns subject to a restocking charge.No returns will be accepted without
prior authorization.In states other than Indiana,AFC is not registered to collect taxes.If taxes are due on this sale
you will be obliged to pay them directly to the various taxing authorities.
REMIT TO: REMIT WIRE TRANSFERS TO: Subtotal $200.74
AFC International Inc JP Morgan Chase
PO Box 894 Account# 134446783 Sales Tax(0.0%) $0.00
DeMotte IN 46310 Bank#074000010
800.952.3293 or 219.987.6825 SWIFT#CHASUS33 Total $200.74
FEIN 36-3836857
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VOUCHER # 155330 WARRANT# ALLOWED
00353173 IN SUM OF $
AFC INTERNATIONAL INC
PO BOX 894
DEMOTTE, IN 46310
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
i
PO# INV# ACCT# AMOUNT i Audit Trail Code
43370 01-7202-06 $200.74
'II
Voucher Total $200.74
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
00353173
AFC INTERNATIONAL INC Purchase Order No.
PO BOX 894 Terms
DEMOTTE, IN 46310 Due Date 4/15/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/15/2015 43370 i $200.74
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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