252962 01/11/16 *. CITY OF CARMEL, INDIANA VENDOR: 00353173
k1 ONE CIVIC SQUARE A F C INTERNATIONAL INC CHECK AMOUNT: $*******278.00*
s. CARMEL, INDIANA 46032 PO BOX 694 CHECK NUMBER: 252962
715C SW ALMOND ST CHECK DATE: 01/11/16
DEMOTTE IN 46310
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 45411 278.00 OTHER EXPENSES
AFC International Inc
PO Box 894 Invoice
.71 SC SW Almond St
,„t T10
DeMotte, IN 46.310 Date Invoice#
12/9/2015 45411
Bill To . Ship To:
Carmel Waste Water Treatment Plant Carmel Waste Water Treatment Plant
Attn Accts Payable Attn Duane Jarvis/S15678
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
Indianapolis IN 46280 : Indianapolis IN 46280
P.O-No. " ' Terms Due DateL
Rep _ Ship Via.
- LL__
S15678 :Net 30 1/8/2016 TGD 12/9/2015 UPS
---
Qty Shipped :B/O ;7 Cat: No. Description., Price Amount
150 150 0 70-18140 :1/8"X 1/4"Tygon 1.80 270.00_ T
Tubing/foot(5155T17)
0 Shipp__(c9 _ w _V_- Shipping'& Insurance Charges ._w 8.00 8 OOT
Tracking No 1 z891 ar30371064423
Thank you for your order.We appreaciate your business.If you have any questions,please contact us at
1.800.952.3293 or fax 219.987.6826.Returns subject to a restocking charge.No returns will be accepted without
prior authorization:In states other than Indiana,AFC is not registered to collect taxes.If taxes are due on this sale
you will be obliged to pay them directly to the various taxing authorities.
REMIT TO: REMIT WIRE TRANSFERS TO: Subtotal $278.00
AFC International Inc JP Morgan Chase
PO Box 894 Account# 134446783 Sales Tax $0.00
DeMotte IN 46310 Bank#074000010
800.952.3293 or 219.987.6825 SWIFT#CHASUS33 Total . $278.00
FEIN 36-3836857
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
00353173
AFC INTERNATIONAL INC Purchase Order No.
PO BOX 894 Terms
DEMOTTE, IN 46310 Due Date 12/17/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/17/201: 45411 $278.00
i
hereby certify that the attached invoice(s), or bill(s) is (are)true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
VOUCHER # 156879 WARRANT # ALLOWED
00353173 IN SUM OF $
AFC INTERNATIONAL INC
PO BOX 894
DEMOTTE, IN 46310
,I
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
�I
I
Board members
i
PO# INV# ACCT# AMOUNT Audit Trail Code
s
45411 01-7200-01 $278.00
I
I
i
I
I
I
Voucher Total $278.00
Cost distribution ledger classification if
claim paid under vehicle highway fund