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245575 05/20/15 ;? CITY OF CARMEL, INDIANA VENDOR: 365496 b ONE CIVIC SQUARE OLDCASTLE ARCHITECHTURAL CHECK AMOUNT: S '384.00* ?a CARMEL, INDIANA 46032 PO BOX 281479 CHECK NUMBER: 245575 ATLANTA GA 30384-1479 CHECK DATE: 05/20/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4239011 210293705 384.00 SPECIAL DEPT SUPPLIES INVOICE INVOICE NO: 210293705 INVOICE DATE: 05/01/15 Northfield DUE DATE: 05/31/15 an Oldcastle company DELIVERY NO: 13685123 Northfield An Oldcastle Company One Hunt Court Remit To: Mundelein, IL 60060 Oldcastle Architectural Phone: 847-949-3600 Fax: 847-816-9072 P.O. Box 281479 Atlanta GA 30384-1479 USA _ PICK UP/SHIP TO: Northfield 901 E Troy Ave MAIL TO: 171679 Indianapolis IN 46203-5192 8665 1 AB 0.406 E0051 10072 D1326246604 P2582331 0001:0001 11111111111-1111-111111111111'1'1'11'1111'1"'111'1'1111111111111 ORDERED BY: 171679 CITY OF CARMEL/STREET DEPARTMENT City of Carmel/Street Department 3400 W 131 ST ST 3400 W 131 st St CARMEL IN 46074-8267 Carmel IN 46074-8267 Contact Boyd Piercy 317-733-2001 Phone 317-659-5823 SOLD TO: 171679 1 City.of Carmel/Street Department L- JOB-NAME... .- ORDER-NO--ORDER-DATE- —--- CUST PO-NO-----" - SALESPERSON — West Clay Cross Walk Repair 1007581052 10/16/14 Yves Legoff TERMS DELIVERY DATE CARRIER F.O.B. Net 30 Days/No Discount 05/01/15 Customer Pickup(CO Only) LN ITEM/ SHIP QTY NET PRICE NON NO DESCRIPTION WHSE U/M PER AMOUNT TAX 2 10155446 233 240.0 1.60 384.00 *Add On-Holland 60mm Antique SFT ITEM TOTAL 384.00 Cash Disc.$0.00 Allowed,if paid by 00/00/00 ORDER TOTAL 384.00 TO VIEW AND PAY ONLINE GO TO I http://oldcastleapg.bilitrust.com/ USE THIS ENROLLMENT TOKEN I SDV MMS QKXJ TAX TOTAL, 0.00 If there is a cash discount printed above,the discount is allowed only if paid in full by the indicated terms.Accounts not paid within terms are subject to INVOICE TOTAL 384.00 being placed on a cash basis,and to pay a finance charge of 1.5%per month(18%per annum)on any past due amount.No credits will be issued for TO PAY USD $384.00 damages or shortages unless noted on delivery receipt. 0001:0001 Page 1 of 1 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. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05/01/15 210293705 $384.00 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Oldcastle Architectural IN SUM OF $ P. O. Box 281479 Atlanta, GA 30384-1479 $384.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I 210293705 I 42-390.111 $384.00 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 `lpurs ' 015 N1#'WVV %-'IV U Title Cost distribution ledger classification if claim paid motor vehicle highway fund