249300 09/09(15 v Coq"
CITY OF CARMEL, INDIANA VENDOR: 357702
ONE CIVIC SQUARE HYDRAULIC COMPONENT SPECIALISTSCHECK AMOUNT: $*******761.00*
s- ° CARMEL, INDIANA 46032 13595 LANDSER PLACE CHECK NUMBER: 249300
CARMEL IN 46033 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9333 761.00 OTHER EXPENSES
Hydraulic Component Specialists Invoice
13595 Landser Place
Carmel, IN 46033 Date Invoice#
8/6/2015 9333
Bill To Ship To
Carmel Wastewater Utility
9609 Hazel Dell Parkway
Indianapolis, Indiana 46280
P.O. No. Terms Account# Job Description
515331. - .- Net 30 ?5026 -
Qty Item Description Unit Price Amount
Reseal/Repair Single Stage Hoist Cylinder
1 Seal Kit 48.00 48.00
1 Retube cylinder 567.00 567.00
1 Enviromental Fee 10.00 10.00
Labor 128.00 128.00
Freight 8.00 8.00
Sales Tax $0.00
Total $761.00
Shop: 5438.Barker Lane Indianapolis, Indiana 46236 Payments/Credits $o.00
Phone (317) 895-6916,
Fax (317) 895-6927 ! Balance Due
$761.00..
Conditional limited warranty as determined by
Hydraulic Component Specialists
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
357702
HYDRAULIC COMPONENTS SPECIALITS Purchase Order No.
13595 LANDSER PLACE Terms
CARMEL, IN 46033 Due Date 8/27/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/27/2015 9333 $761.00
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
Date Officer
VOUCHER # 156176 WARRANT # , ALLOWED
357702 IN SUM OF $
HYDRAULIC COMPONENTS SPECIALI'
13595 LANDSER PLACE
CARMEL, IN 46033
Carmel Wastewater Utility i
ON ACCOUNT OF APPROPRIATION FOR
Board members
i
PO# INV# ACCT# AMOUNT Audit Trail Code
9333 01-7502-06 $761.00
I
I
I
Voucher Total $761.00
Cost distribution ledger classification if
claim paid under vehicle highway fund