HomeMy WebLinkAbout259049 05/31/16 +ur.4�AN
JY CITY OF CARMEL, INDIANA VENDOR: 00350590
ONE CIVIC SQUARE HOOSIER RUBBER &TRANS-DO NOT UgLHECK AMOUNT: $********43.35*
s. =a CARMEL, INDIANA 46032 3905 E PROGRESS STREET CHECK NUMBER: 259049
+.y�TON� NORTH LITTLE ROCK AR 72114 CHECK DATE: 05/31/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 H11224-001 43.35 OTHER EXPENSES
VOUCHER # 165374 WARRANT # ALLOWED
350590 IN SUM OF $
RGA/HOOSIER RUBBER & TRANSMIS!
3905 E. Progress Street
North Little Rock, AR 72114
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
H 11224-001 01-7200-02 $43.35
Voucher Total $43.35
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
350590
RGAMOOSIER RUBBER&TRANSMISSON Purchase Order No.
3905 E. Progress Street Terms
North Little Rock, AR 72114 Due Date 5/23/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/23/2016 H 11224-001 $43.35
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
Date Officer
INVOICE
MAIL REMITTANCE TO: ENTERING OFFICE INVOICE NUMBER TRAN
CODE
RGA H1 1224-001 DI
RGA 2002 LAFAYETTE RD. INVOICE DATE PAGE
INDIANAPOLIS IN 46222 05/13/16 1
AN EMPLOYEE OWNED COMPANY
3905 East Progress Street
Any different or additional terms that may be embodied in your purchase order are hereby objected to. If your order is not an
North Little Rock, AR 721 14 acceptance of our proposal,this will operate as an acceptance of your order only in the event you agree to the terms hereof.
The terms and conditions contained above and attached shall apply.
LIME.............. .. ..:.......:.:.......: ..:. :::.:::..::::::.::: .:..::::..:::PA1•.1!11 $ 4:::::.::::::::::::::.::: ::::::::::::k1itEE.T..:Q>:A #4SUii�...::::...:.::::.1JE1:1?IfG...:....:::......:...... X....... ......:..
:: :>::>:<:»:<::::>::»:<:::::::>::>:: :.mak..:::::..:::.•::;:::::.;:•A b'
::.;Nf)::»::;�;:::. ;:.;:.;R�SGI3fP.•:3'1[7AE:.;;:::.;:.::.;:.::.;;:.;:;;:;.; G3........................... X.
.......
10 1 1 DMH2O25F 38.1000 38.10
DBL M HX NPL 2N DIX EA
PT X 2 1/2 NST
20 1 1 200-A-AL 5.2500 5.25
ADAPTOR DIX EA
I
FOLD
CUST.NO. ORDER DATE TERR PC ORD Written By DATE SHIPPED WHSE AMOUNT 43.35
TC125 05/13/16 TD 70 S TJS 05/13/16 70
FRGHT/INS/HNDL .00
Carrier: WILL CALL FOB: SP,FNA,PREPAID ORIGINAL INVOICE .
Tracking: — - -- — ---- SALES TAX 00
Terms of Payment: NET 30 DAYS INVOICE TOTAL 43.35
Please Pay This Amount
ORDER ISSUED IN: INDIANAPOLIS
Note New Remit To Address: PHONE: 317/634-3976
3905 East Progress Street
North Little Rock, AR 72114
Customer PO No. S16108 Mark No.
s CARMEL UTILITIES s CARMEL WASTE WATER
0 9609 HAZELDELL PKWY H 9609 HAZEL DELL PARKWAY
T INDIANAPOLIS IN 46280 T INDIANAPOLIS IN 46280
0 0
From: RGA
RG- -A- 2002 LAFAYETTE RD.
AN EMPLOYEE OWNED COMPANY INDIANAPOLIS IN 46222
CUST
P.O.NO
:: :::Iy.,..::: ::: .:•:;:;;;::.:i.:.::':;:;:r�:;:;:::::'::r::::::::::'::::::'`::::;:'.::;<:::::::'••::::::'::::3::i.:::. 9:::
................::::::::..:::. IN
::.::::::.
:::: ::::.:::::::::::::::::::::::•:::::::::::::::...MARK ... :::::::::::::::::. : : .:::: . MARK
:: >:>>:...........NO. ....> :::............>:::::::::::>::»::>::::<.::::::::<:.??>::#::>::::»::::s>::::::::;;::::>?::::»: .................................... NO. JEFF PO TO FOLLOW
S S
O CARMEL UTILITIES H CARMEL WASTE WATER
L 9609 HAZELDELL PKWY 1 9609 HAZEL DELL PARKWAY
D P
T INDIANAPOLIS IN 46280 T INDIANAPOLIS IN 46280
0 0
ORDER DATE SALES ORDER NO. PAGE WRITTEN ORIGIN
05/13/16 H11224-001 1 TJS 70
:it"�`HIP:ifiii
....S .MENT FR"iui. `uA '.NIAN�AP:.:{<>:»; >> >>> «; :>:;<:;<:;>::::<:::><:�:>
..::::::::::: ::.::::::::::::::::::::::.:....,::.:::::::::::::.::::.:::::.xx::.:::::::.:::.:..:.:.::.:::.:.
Q.....0.........:......................:...:...:..::::::::•:::::::::WAREHUU.S..E::.
..............................................................................................................................,,.
UNE CURRENT PART NUMBER UNIT QUANTITY
OF
NO. QUANTITY DESCRIPTION PRODUCT WEIGHT MEAS RELEASED SHIPPED
10 1 DMH2O25F EA 1
DBL M HX NPL 2N DIX 1 .4200
PT X 2 1/2 NST
20 1 200-A-AL EA 1
ADAPTOR DIX .4500
QUESTIONS ABOUT YOUR ORDER? CALL 317-634-3976
We hereby certify that these goods were produced in compliance with THE PRODUCTS LISTED ABOVE MEET THE
all applicable requirements of Section 6,7,and 12 of the Fair Labor REQUIREMENTS AND SPECIFICATIONS OF THE
Standards Act,as amended,and of regulations and orders of the STANDARDS UNDER THE OCCUPATIONAL PACKING
t�++�/ 1��//++ T
United States Department of Labor issued under Section 14 thereof. SAFETY AND HEALTH ACT OF 1970. PACKING LIS 1