251886 1 2/02/1 5 �% �,q,,f. CITY OF CARMEL, INDIANA VENDOR: 007000
J �; ONE CIVIC SQUARE ACORN DISTRIBUTORS INC CHECK AMOUNT: $*******391.86*
,� �;� CARMEL, INDIANA 46032 5820 FORTUNE CIRCLE DR.WEST CHECK NUMBER: 251886
y`�«oN�. INDIANAPOLIS IN 46241 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4238900 223713600 391.86 OTHER MAINT SUPPLIES
ACORN lNVO/CE
D i s t r i b u t o r s, - n c _
S.F.Clops for Che J.nJt.,1.1 R Foodservice Industries
5820 Fortune Circle Dr.West
Indianapolis, IN 46241
Phone: (317)243-9234, (800)783-2446
Fax: (317) 260-2289
vvwvv.acorndistributors.com III IIII�III� II IIII�IIIIIIIIIIIIIIIII 0
0:56 11/13 15 RD
4. PagelJH
Invoice # SR/WHSE USER REPRINT
2237136-00 01/01 WEB 1
S CARMEL CITY HALL S CARMEL CITY HALL
0 T ATT: JEFERY BARNES H T ONE CIVIC SQUARE
L 0 ONE CIVIC SQUARE I 0 CARMEL IN 46032
D CARMEL IN 46032 P
Tel 317-571-2448 Fax 317-571-5845
ORDER CUSTOMER CUSTOMER P/0 TERMS TAX SHIP SALES JOB
DATE NUMBER NUMBER CODE CODE VIA PERSON ID/NAME
11/10115 0007615 - NET 25 DAYS ZINE/7.000'/o Tk P4/006 Platte, John 79998
LN# Q—ORD Q—SHP Q—B/O PRODUCT UOM UNIT—PRICE EXTENSION WEIGHT VOLUME T
1) 1 1 0 DIX5342CD CS 109 . 56 $109 . 56 26 . 5 3 . 6 N
Cup 12 oz Perfect Touch Insulated Paper 1M/cs
2) 5 5 0 CLOX15949 CS 37 . 71 $188 . 55 44 . 5 2 . 7 N
WIPES Disinfectant Fresh 6/75ct canister
3) 10 1.0 0 SWIB50 BG 8 . 58 $85 . 80 500 0 N
Industrial Blue Ice Melt 50LB 50/pallet
***** Special Instructions *****
* 8-5 MONDAY—FRIDAY
**********************************
Sub—Total . . . . . 383 . 91
Fuel Surcharg. . 7 . 95
Tax . . . . . . . . . . . 0 . 00
Order Total . . . 391 . 86
Building Maintenance
Account * 3K?-- ,
-_ Department# -1241 Subluitted To -
NOV 3 0 2015
Clergy Tri' surer
TOT: 16 16 0 571 6
Received in Good Condition: Ship Date 11/13/15 Loc
Volume Picked by DC
Weight
Pieces Packed by
Terms & Conditions Pallet
Returned items are subject to a 25% restocking Pkgs Checked by
fee and return freight costs. Ctns
Lnth Loaded by
X:
VOUCHER NO. WARRANT NO.
ALLOWED 20
ACORN DISTRIBUTORS INC
5820 FORTUNE CIRCLE DR. WEST r IN SUM OF$
i
INDIANAPOLIS, IN 46241
$391.86
ON ACCOUNT OF APPROPRIATION FOR
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members
I 1237136-00 I 42-389.00 I $391.86 1 hereby certify that the attached invoice(s), or
120.5 101
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
Monday, November 30, 2015
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
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.
I
Payee
Purchase Order No.
Terms
Date Due
Invoice Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
11113/15 1237136-00 $391.86
1205 101
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
120
Clerk-Treasurer