252686 12/15/15 9, r Coq .
y�- "° CITY OF CARMEL, INDIANA VENDOR: 00351017
® i} ONE CIVIC SQUARE KIRBY RISK CORPORATION CHECK AMOUNT: $ .....'31.92"
CHICAGO CARMEL, INDIANA 46032 27561 NETWORK PLACE CHECK NUMBER: 252686
�, roN.�` CHICAGO IL 60673-1275 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 108413822001 31.92 OTHER EXPENSES
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
• ;R CUSTOMER PO
74918 S15637 PT 10TH PROX NET 30TH
SALESPERSONSHORDERED'B� SALES OFFICE PHONE NUM13ER: 10 DATE
DARREN HARING PK PICK-UPJEFF COOPER FISHERS 317-598-6170 11/25/15
• . • . . • •
4ea 4ea BATO PS-640F1 7.98 lea 31.92 0.64
6 volt 4.5 AH SLA battery
Billing Questions: Billing_request@kirbyrisk.com(765)446-3054 11125120153:24:40PM s10E413822.001 Invoice Number S108413822.001
Subtotal 31.92
If paid by 12/10/15 you may deduct$0.64 S&H Charges 0.00
Invoice is due by 12/31/15 net of any cash discount. Sales Tax 0.00
JEFF COOPER 31.92
000t:000l Kirby Risk Page 1 of 1
TERMS AND CONDITIONS OF SALE
ACCEPTANCE OFTHE GOODS PURCHASED ON MIS INVOUCECONS'l HTFES AND
ACCEPTANCE OFTHETERMS AND CONDITIONS OF SALE 'WHICH FOLLOW:
(1) StocK Merchandise is.-;ub,jectio a rci,aii c1mrL,,:. No iz,00ds nia\ be NWITCd Witi-.0LIt a "shYpi]1,4 tiJ'tA
and invoice number und prior authori/anon.
(2) Non-Stock Merchandise is not returnable urlc;,; kcc cmi �ccurei"ROL11-Tied Goods Authority" from
the vendlor.
(3) The 0istoma acknm%]�,.dpc� and agrees that in all purchases of goods and-,crvict•s firom S,Alcr. Scll,2r
I
give:ro,",Cl war-,)Iltics, or 1:14�lcd vNarruniics of rncrclianla�)'ility and taness, iter in-, 1);irtict'lkir
(4) 1-he CAIStOrlIff:ILITCCI;that Sc.11,:r will not be liable for aHVV consC(.juclitvll aold
fp)l- allv with the goods purchased front Sellet
rcM P�—ISi'..; 1, S--,!,-,:I."!-1,1i i I,11 S-,611 h'J J d-d, to th-. U C hJ. +rit'c I u
rc,jrnburse Seller for anv such tax oi-provide Seller vvith accepiaole tax cxenipuoij caiificaw.
(6) Delaly in DoliverN –Seller l,< rot to I-)!:, accountable for deluvs in dclivcry occasioned by acts ot'Goin Or
Wha cii-CLIMSTIMCCS over Seller 11215 no direct cilmtrol. shipment cil delivery datez are the
bes-t.C,t11TKflW.,of our suppliers,and ii, no case shall Scll(:r be ha'Mc f0l'JN)% C0111SC,JUCTAM! 01-S]ICC1,11
d�`IIMWTS arising from ariv delay in deliVerIV.
(7) Wadver -The of Sellcr to insist upon the performance ol'any ofthe or conditions of thli,
contract of to cxcr�:Isc flayri-lit herea.nder shall not be deemed to be a-waiver of Such terms;
conditions or ri0i I in the future,nor shall it be deemed to be a waiver of any other term, cordiijo-,,,,or
right under this contract.
(8) Modification of Terms and Conditions--No terms lind conditions other than those slated herein. and
no aarcerricrit or Understanding. in arty way purporting to modify these terms,or conditions.shall be
binding on Seller Without Seller's \L.i,ittcn conscrtt.
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
351017
KIRBY RISK ELECTRICAL SUPPLY Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 12/8/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/8/2015 S108413822. $31.92
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 # 156820 WARRANT # ALLOWED
351017 IN SUM OF $
KIRBY RISK ELECTRICAL SUPPLY
PO BOX 664117
INDIANAPOLIS, IN 46266
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
S108413822.( 01-7202-05 $31.92
Voucher Total $31.92
Cost distribution ledger classification if
claim paid under vehicle highway fund