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302197 08/22/16
CITY OF CARMEL, INDIANA VENDOR: 370843 ® F, ;• ONE CIVIC SQUARE MADDOX INDUSTRIAL GROUP INC CHECK AMOUNT: $*****8,990.00* x ? CARMEL, INDIANA 46032 3771 S.US HIGHWAY 31 CHECK NUMBER: 302197 FRANKLIN IN 46131 CHECK DATE: 08/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 150839 8,990.00 OTHER EXPENSES Voucher No. Warrant No. ACCOUNTS PAYABLE DETAILED ACCOUNTS MUNICIPAL WATER DEPT. "No?. 3-)OS3 CARMEL, INDIANA Favor Of �i�-old©X 3 �� 40 tlli,Y 3l /"RANK!;,U -r,,j 11613/ Total Amount of Voucher $ Deductions ®;. 4.0z Amount of Warrant $ Month of Yr VOUCHER RECORD Acct. No. Source of Supply Water Treatment Transmission and Dist. Customer Accounts Administrative and General Operation-Maintenance Utility Plant in Service Constr.Work in Progress Materials and Supplies Customers Deposits Total Allowed Board of Control Filed Official Title BOYCE FORMS•SYSTEMS 1-800-382.8702 325 Prescribed by State Board of Accounts Form No.301(Rev.1995) ACCOUNTS PAYABLE VOUCHER TO ADDRESS Invoice Date Invoice Number Item Amount I hereby certify that the attached invoice(s), or 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 Mo. Day Yr. Signature Title 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. Mo. Day Yr. Officer Title M1 Aft MADDOX INDUSTRIAL GROUP INC. Invoice 3771 S. US HIGHWAY 31 Date Invoice# MADDOX INDUSTRIAL GROUP FRANKLIN, IN 46131 317-870-2400 6/9/2016 150839 Terms Due Date Bill To Net 30 7/9/2016 CARMEL WATER DEPARTMENT 3450 W 131st ST CARMEL,IN 46074 P.O. No. JC2016-13 WTP CHECK VALVES Quantity Description Rate Amount 100%o COMPLETE 8,990.00 8,990.00 CARMEL WTP CHECK VALVES Please remit to above address. Total $8,990.00 Ifyou have any questions concerning this invoice,please call 317-870-2400. Due net 30 payments/Credits $0.00 days from date of invoice. All unpaid invoices are subject to mechanics lien. Past due Invoices are Subject to a Service Charge of 1.5%per month,$100.00 Balance Due $8,990.00 Minimum.