246853 06/30/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 360376
ONE CIVIC SQUARE INDUSTRIAL MAINTENANCE SOLUTIONCHECK AMOUNT: $*******141.25*
CARMEL, INDIANA 46032 PO SOX 318 CHECK NUMBER: 246853
WESTFIELD IN 46074 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4238900 95566 141.25 OTHER MAINT SUPPLIES
Remit to:
Invoice P.O. Box 6457- Dept.#274
Indianapolis, IN 46206
Industrial Maintenance Solutions Invoice Number: 0095566-IN
a division of Correlated Products, Inc. Invoice Date: 6/17/2015
Road Solutions, Inc. Customer Number: 9001001
5616 Progress Road
P.O. Box 42387
Indianapolis, IN 46242-0387
Sold To: Ship To:
CARMEL, CITY OF (FIRE DEPT) CARMEL FIRE DEPT
3610 W. 106TH 2 CIVIC SQUARE
ATTN: SCOTT OSBORNE ATTN: SCOTT OSBORNE
CARMEL, IN 46032 CARMEL, IN 46032
Customer P.O. Ship VIA Terms
NET 15 DAYS
—"Ordered—Shipped Back Ord Unit Item Code Description Price Amount
1 1 0 DR 1211-015 FORCE ULTRA HEAVY DUTY DEGR 134.25 134.25
1 1 0 EA 2223-000 Z/P PROPORTIONER#KP1 H 0.00 0.00
Net Invoice: 134.25
Frt/Petroleum Surchg: 7.00
Sales Tax: 0.00
Invoice Total: 141.25
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))
95566 $141.25
1 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
Industrial Maintenance Solutions
IN SUM OF $
P.O. Box 318
Westfield, IN 46074
$141.25
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 95566 42-389.00 $141.25 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 j 1N 2 9 2915
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund