249757 09/23/15 r Coq
��' "F CITY OF CARMEL, INDIANA VENDOR: 366764
® it ONE CIVIC SQUARE K M INTERNATIONAL CHECK AMOUNT: $ 62.88`
�., _ CARMEL, INDIANA 46032 6561 BERNIE KOHLER DRIVE CHECK NUMBER: 249757
+,;,_i�N�• NORTH BRANCH MI 48461 CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 8114 62.88 REPAIR PARTS
INVOICE
WMAWCNAL
6561 Bernie Kohler Drive Date Invoice#
North Branch, MI 48461 7/16/2015 8114
Bill To Ship To
CITY OF CARMEL CITY OF CARMEL
3400 W. 131ST 3400 W. 131ST
CARMEL,IN 46074 CARMEL,IN 46074
S.O. No. P.O. No. Terms Due Date Rep Territory C... Ship Via INCOTERM
11512 bentley Net 30 Days 8/15/2015 GW 30 7/16/2015 UPS GND
Quantity Description Rate Amount
1 KM4000/8000T AUTOMATIC CHANGEOVER PROPANE REGULATOR, 1/4"FIF x 3/8" 45.10 45.10
FPT
1 HANDLING/PACKAGING AND/OR CRATE CHARGES 7.50 7.50
I UPS-GROUND# IZ 7E9 IEl 03 5898 6380 10.28 10.28
1.25%Late Fee On All Past Due Invoices-Assessed Monthly Total f $62.88
Payments/Credits $0.00
Balance Due $62.88
Phone# Fax# E-mail Web Site
810-688-1234 810-688-8765 ginger@1Qninternational.com www.kmintemational.com
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))
07/16/15 8114 $62.88
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
KM International
IN SUM OF $
6561 Bernie Kohler Drive
North Branch, MI 48461
$62.88
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
T
2201 I 8114 I 42-370.001 $62.88 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
ursday,, ,t * 5
401
i°tt^uat f�ra+ aysee;�
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund