312682 06/16/2017 �ur C�N11
CITY OF CARMEL, INDIANA VENDOR: 00351017
ONE CIVIC SQUARE KIRBY RISK CORPORATION CHECK AMOUNT: $"""**"*341.70*
,� ?�: CARMEL, INDIANA 46032 27561 NETWORK PLACE CHECK NUMBER: 312682
CHICAGO IL 60673-1275 CHECK DATE: 06/16/17
MirpN i�'
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 S109282118 341.70 5109282118 .001
777�777777777`
N
N
G
m
O (D
2 'sW W U
Ix
s Z J 0
CL o
o. it
= z
a 3
ca
d a V c
a v n
ti
V d LL Q o H m e
W p cot >
1 co ~ v r
N J =O Z o G
j = Z O U12
cc Y1
oma c� V z E
co C-4 a U
{
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER • •• NUMBER RELEASE NUMBER TERMS
74918 S17262 PT 10TH PROX NET 30TH
SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE
JEREMIAH S ELY 23 INDIANAPOLIS DUANE JARVIS FISHERS 317-598-6170 05/26/17
ORDER • P QTY DESCRIPTION ITEM PRICE UNIT EXTAMOUNT
30ea 30ea PHIL 10T8/48-4000 IF 10/1 11.39 lea 341.70 6.83
468280
Billing Questions:Billing_request@kirbyrisk.com(765)446-3054 05-26-201710:59:13 AM Invoice Number S109282118.001
Subtotal 341.70
If paid by 06/10/17 you may deduct$6.83 S&H Charges 0.00
Invoice is due by 06/30/17 net of any cash discount. LU��/ /'/�� T 0.00
,, ,,,, DaadT 341.70
0001:0002 IV( Kitty RISK Page 1 of 1