245844 06/03/15 �,_Cqq
`� "'' CITY OF CARMEL, INDIANA VENDOR: 358710
® } ONE CIVIC SQUARE H D SUPPLY WATERWORKS LTD CHECK AMOUNT: $*******218.20*
r �a: CARMEL, INDIANA 46032 P O BOX 28330 CHECK NUMBER: 245844
+.y«oN ST LOUIS MO 63146 CHECK DATE: 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 D897075 218.20 OTHER EXPENSES
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You.__ _
-- -- - - -- ----- — ---�—` --- _-We appreciate your prompt payment.
Date Ordered Date Shipped Customer PO No. Job Name Job No. Bill of Lading Shipped Via Order Number
5/07/15 1 5/07/15 S15087 STOCK OUR TRUCK D897075
Product Code Description Quantity Quantity Back- Price Per Amount
Ordered Shipped Ordered
Ord by: DUANE
65REMH26 26"REED MANHOLE HOOK MH26 2 2 27.3000 EA 54.60
#02301
65REMH36 36"REED MANHOLE HOOK MH36 2 2 34.7000 EA 69.40
#02303
281OCCLCISR 1002-1010SR 10X10 SHEAR RING 2 2 47.1000 EA 94.20
CPLG CLXCI/PVC W/BAND
This transaction is governed by and subject to HD Supply Waterworks standard terms Terms SubTotal
and conditions,which are incorporated herein by this reference and accepted.
To review these terms and conditions,please point your web browser to NET 30 218.20
http://waterworks.hdsupply.com/TandC/.
Freight Delivery Handlina Restock Misc. Tax •
• $218.20
INDIANAPOLIS IN THANK YOU FOR YOUR ORDER DB97075
Branch-509 VISIT
7281 East 30th St WATERWORKS.HDSUPPLY.COM
Indianapolis IN 46219 FOR OTHER SERVICES OFFERED
0001:0001 Page 1 of 1
VOUCHER # 155562 WARRANT # ALLOWED
86201
IN SUM OF $
HD SUPPLY WATERWORKS LTD (NAT
PO BOX 28330
ST. LOUIS, MO 63146
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
1�
ti Board members
PO# INV# ACCT# AMOUNT 1 Audit Trail Code
I
D897075 01-7200-02 $218.20 �f
I
1
i
i
Voucher Total $218.20
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
i
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
86201
HD SUPPLY WATERWORKS LTD (NATIONAL Purchase Order No.
PO BOX 28330 Terms
ST. LOUIS, MO 63146 Due Date 5/27/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/27/2015 D897075 $218.20
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
A
Date Officer