249038 08/26/15 CIF"
%` "� CITY OF CARMEL, INDIANA VENDOR: 294850
® {• ONE CIVIC SQUARE STOOPS FREIGHTLINER CHECK AMOUNT: $""'*""38 29'
,_� CARMEL, INDIANA 46032 27825 NETWORK PLACE CHECK NUMBER: 249038
'•y�roN.�. • CHICAGO IL 60673-1278 CHECK DATE: 08126115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 X30106641500 38.29 OTHER EXPENSES
INVOICE NO. X301066415:01
INVOICE DATE 07/31/2015
P.O. NUMBER 15341
jemlIGMUNIH-111A111Y TRAIIfR SHIP VIA PICKUP
HIVISIONOFREFERENCE
r� 9J0 TRUCK COUNTRY- INDIANAPOLIS
_ __...__._____..--___ .. _ 1851 W THOMPSON ROAD
I �v ALL CLAIMS AND RETURNED GOODS MUST BE ACCOMPANIED BY THIS INVOICE.NO RETURNS ON
ELECTRICAL OR SPECIAL ORDER PARTS.NO RETURNS WITHOUT THIS INVOICE.NO RETURNS INDIANAPOLIS, IN 46217
AFTER 30 DAYS. THERE WILL BE AN UP TO 25%RESTOCKING FEE PLUS FREIGHT CHARGES ON , Phone: (800)899-1533 FAX: (317)781-4370
I ALL RETURNED PARTS.NO RETURNS ON ANY PARTS WITH A VALUE LESS THAN$50.
Bill To: Ship To:
CARMEL UTILITIES 168200 CARMEL UTILITIES 168200
ONE CIVIC SQUARE ONE CIVIC SQUARE
CARMEL , IN 46032 CARMEL, IN 46032
Phone: (317)571-2443 Phone: (317)571-2443
INVOICE NO. X301066415:01
DATE SHIPPED TERMS SALESPERSON WRITER SHIP VIA UNIT ID VIN
7/31/2015 CHIS S1398
QTY QTY UNIT EXT
SHIP B/O ITEM DESCRIPTION BIN 1 PRICE PRICE
1 0 301D/FG LF9009 PACKAGE,LUBRICATION FILTER''- U0208 38.29 38.29
0`•�S�a Flo
SALES TAX EXEMPTION CERTIFICATE DISCLAIMER OF WARRANTIES -
I rarefy that this transaction is exempt from the Indiana Sales Tax because ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MADE Subtotal 38.29
Purchaser is a Common Contract canner who will use Items purchased or serviced BY MANUFACTURER,IF ANY THE SELLER HEREBY EXPRESSLY
excluswely as such Carrier. DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR IMPLIEDANCLUDING
ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FORA TAX 0.00
Authority Number PARTICULAR PURPOSE,AND TRUCK COUNTRY OF Indian.NEITHER
Purchaser is engaged in the business of and items well be used for resale ASSUMES NOR AUTHORIZES ANY OTHER PERSON TO ASSUME FOR IT ANY
LIABILITY IN CONNECTION WITH THE SALE OF SAID PRODUCTS WE TaxDes2 0.00
Resale Number: HEREBY CERTIFY THAT THESE GOODS WERE PRODUCED IN COMPLIANCE
WITH ALL APPLICABLE REQUIREMENTS OF SECTIONS 6,7 AND 12 OF THE
I am authorized to execute this CeNihcate and claim this exception FAIR LABOR STANDARDS ACT OF 1938.AS AMENDED AND OF
REGULADIVISION TISSUEDNUUNDERORDERS OF THESECT ON 14ATDHEREOMINISTFATRUCK OUNTRY DOES TOR OR WAGE AND R Total: 38.29
EXPRESS A LIMITED NON�TRANSFERRASLE WARRANTY,TO THE ORIGINAL
Busmoss Name Authorized Signature PURCHASER,ON TECHNICIAN WORKMANSHIP ISSUES FOR 30 DAYS FROM
THE COMPLETION DATE OF THIS REPAIR ORDER A FINANCE CHARGE OF
ONE AND ONE-HALF PERCENT T'A%)PER MONTH IS APPLIED TO ALL
ACCOUNTS 30 DAYS PAST DUE THIS EOUALS AN ANNUAL PERCENTAGE
Business Address Date RATE OF EIGHTEEN PERCENT(18%).
RECEIVED
BY
Please Remit Payment to:
Delivered by: 3®9 27825 NETWORK PLACE
Date: STOOPS FREIGHTLINER
/
Customer Signature: - l.? 1
CHICAGO,IL 60673-1278
SIGNATURE OY THE CUSTOMER OR CUSTOMER REPRESENT E CONSTITUTES AGREEMENT TO PAY REASONABLE LEGAL EXPENCES,
INLCUOINO ATTORNEY AND COURT COSTS INCURRED RUCR COUNTRY FOR PAYMENT OF TNI4 INVOICE.
CUSTOMER SIGNED COPY Page 1 of 1
MAIL COPY WILL BE SENT
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
;;
VOUCHER M 156136 `•NARRANT '� ALLOWED �—
294850 —` HNI SUP.v1 Or S
STOOPS FREIGHTLINER
P O BOX 633838 -- -------- -- -- —
CINCINNATI, OH 45263-3838
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
X301066415:( 01-7502-06 $38.29
Voucher Total $38.29
Cost distribution ledger classification if
claim paid under vehicle highway fund
I