308144 02/13/17 \. CITY OF CARMEL, INDIANA VENDOR: 358402
ONE CIVIC SQUARE I D S CHECK AMOUNT: $********13.20*
CARMEL, INDIANA 46032 2717 TOBEY DRIVE CHECK NUMBER: 308144
INDIANAPOLIS IN 46219 CHECK DATE: 02/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 0183709-IN 13.20 REPAIR PARTS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor358402 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
# IN SUM OF$
IDS CITY OF CARMEL
2717 TOBEY DRIVE An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
INDIANAPOLIS, IN 46219
Payee
$13.20
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
0183709-IN 42-370.00 $13.20 1 hereby certify that the attached invoice(s),or 1/23/17 0183709-IN $13.20
2201 201 2201 201
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
Tuesday,January 31,2017
Huffman, Dave
Director
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
, 20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
C��1;IiRgr�`�v
(317)-545-06651)
Invoice
1 (317)-545-0670
YL+'Alto Customer No: 0105029
c, Invoice No: 0183709-IN
2717 Tobey Dr
Indianapolis, IN 46219
Bill To: City of Carmel Street Dept. Ship To: City of Carmel Street Dept.
3400 W. 131 st Street 3400 W. 131 st Street
Westfield, IN 46074 Westfield, IN 46074
Date: I Ship VIA F.O.B. Tracking No. Terms
1/23/2017 WILL CALL Net 30
Purchase Order No. Order Date Account Representative Our Order Number
Jim 1/23/2017 John Heinzelman 0093962
Quantity
Required 1 Shipped B.O. Item Number Description Unit Price Amount
4.00 4.00 0.00 888-2263-00108PE Handle, Control, Pneumatic#2, 3.3000 13.20
Safety Flap
Net Invoice: 13.20
Less Discount: 0.00
Freight: 0.00
Sales Tax: 0.00
Invoice Total: 13.20
SEE WARNING ON REVERSE SIDE OF THIS DOCUMENT. THANK YOU FOR YOUR BUSINESS
G�ti�,{ItA��l�o
(317)-545-0665
(317)-545-0670 Packing Slip,
k,
Customer No: 0105029
a' o Order No: 0093962
2717 Tobey Dr Shipping No: 0183709
Indianapolis, IN 46219
Bill To: City of Carmel Street Dept. Ship To: City of Carmel Street Dept.
3400 W. 131 st Street 3400 W. 131 st Street
Westfield, IN 46074 Westfield, IN 46074
Date: Ship VIA F.O.B. _ Terms
1/23/2017 WILL CALL Net 30
Purchase Order NumbeRequired Date Account Representative Order Entered By Our Order Number
Jim 1/23/2017 John Heinzelman WCD 0093962
Quantity
Reauired Shiooed B.O. U/M Item Number Description
4 4 0 EACH 888-2263-00108PB Handle,Control, Pneumatic#2,Safety Flap
o �
Picked By Packed By Package Count Weight Charges
SEE WARNING ON REVERSE SIDE OF THIS DOCUMENT. THANK YOU FOR YOUR BUSINESS
Please note: There is a 20%re-stocking fee on all customer returns.