318802 11/21/2017 +us Cgq�R
CITY OF CARMEL, INDIANA VENDOR: 00351017 CHECK AMOUNT: S""""""'68 82'
ONE CIVIC SQUARE KIRBY RISK CORPORATION
CARMEL, INDIANA 46032 27561 NETWORK PLACE CHECK NUMBER: 318802
CHICAGO IL 60673-1275 CHECK DATE: 11/21/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTIOOTHER EXPENSES N
651 5023990 68.82
$ _ INI o
w
lu
OC" �Tl z
a v
Zr
r
d rt v �^ Et
3 g W
or 0
MR
v
H
01 o f+ v
I
a c. Q X
IA � $,
... C
a
N � r
v
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER • •• NUMBER RELEASE NUMBER TERMS
74918 S17785 PT 10TH PROX NET 30TH
SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE
RICH R COLLINS PK PICK-UP BEN DONALD FISHERS 317-598-6170 1 11/03/17
ORDER QP CITY DESCRIPTION
2ea 2ea CRSH TP518 150.04 100ea 3.00 0.06
RS-13 4 SQ SURFACE CVR
70ft 70ft SOUT THHN-STR-6-BLA-CU-1000FT 470.11 1000ft 32.91
6-19 CU SIMpull(TM)THHN-THWN-2
MTW-AWM BILK
20493305
70ft 70ft SOUT THHN-STR-6-BLA-CU-1000FT 470.11 1000ft 32.91
6-19 CU SIMpull(TM)THHN-THWN-2
MTW-AWM BLK
20493305
Billing Questions:Billing_request@kirbyrisk.com(765)446-3054 11/3/2017 9109549214.001 Invoice Number S109549214.001
Subtotal 68.82
If paid by 12/10/17 you may deduct$0.06 O^�D S&H Charges 0.00
Invoice is due by 12/31/17 net of any cash discount. Sales Tax 0.00
,,rr,�, aa BM n = • 68.82
0001:0001 MR Kirby Risk Page 1 of 1