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252054 1 2/02/1 5 CITY OF CARMEL, INDIANA VENDOR: 358990 ONE CIVIC SQUARE MUNICIPAL EMERGENCY SERVICES CHECK AMOUNT: $*****3,000.00* CARMEL, INDIANA 46032 DEPOSITORY ACCOUNT CHECK NUMBER: 252064 9�'i'roN 75 REMITTANCE DR STE 3135 CHECK DATE: 12/02/15 CHICAGO IL 60675 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 00674190 3,000.00 OTHER EXPENSES Invoice - MES-Indiana Number ......:00674190_SNV 6975 Hillsdale Court Date .........:9/29/2015 olis, IN 46250 Page ...........:1 of 2 Indianapolis, Sales order ..:SO 582175 a+urupvxbacrsc�nic�a Requisition ... Your ref. ...... Telephone :(888)322-8402 Our ref. ......:AUlrich Fax ........:317-596-1701 Payment .....:Net 30 Sales Rep ...:kschulthei Inv Acct ......:46665 Bill To: Ship To: CITY OF CARMEL UTILITIES CITY OF CARMEL UTILITIES 3450 WEST 131ST.STREET 3450 WEST 131ST.STREET Westfield,IN 46074 Westfield,IN 46074 KERRILOVEALL Item number _ Size Color Description Quantity Unit Unit price Amount T Used Airpak Used Airpak 5.00 Fro 600.00 3,000.00 USED AIR PAK INCLUDING PAK,REGULATOR,FACEPIECE AND CYLINDER 200450-01 ASSY HOSE,HUD SOCKET 1.00 EA 0.00 OD-AP75 Merchandise Restocking Fee S&H Sales tax Discount Total due 3,000.00 0.00 0.00 0.00 0.00 3,000.00 USD Thank You For Your Order ! All returns must be processed within 30 days of receipt and require a return authorization number and are subject to a restocking fee. Custom orders are not returnable.Effective tax rate will be applicable at the time of invoice. VOUCHER # 153604 WARRANT# ALLOWED - 358990 IN SUM OF $ MUNICIPAL EMERGENCY SERVICES 75 REMITTANCE DR + SUITE 3135 CHICAGO, IL 60675 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR }; i Board members 5 PO# INV# ACCT# AMOUNT Audit Trail Code 00674190 01-6200-04 $3,000.00 i i I 1 I Voucher Total $3,000.00 Cost distribution ledger classification if claim paid under vehicle highway fund 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 358990 MUNICIPAL EMERGENCY SERVICES Purchase Order No. 75 REMITTANCE DR Terms SUITE 3135 Due Date 11/17/2015 CHICAGO, IL 60675 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/17/201: 00674190 $3,000.00 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 it AyhS C.awTt i Yom. Date Officer