HomeMy WebLinkAbout321867 02/13/18 y u,1 C�NM
u/ `• CITY OF CARMEL, INDIANA VENDOR: 00351017
.( d
ONE CIVIC SQUARE KIRBY RISK CORPORATION
CHECK AMOUNT: S**"""""124.00"
a CARMEL, INDIANA 46032 27561 NETWORK PLACE CHECK NUMBER: 321867
CHICAGO IL- 60673-1275 CHECK DATE: 02/13/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 124.00 S109662300001
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) .
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 00351017
KIRBY RISK CORPORATION - IN SUM OF$ CITY OF CARMEL
27561 NETWORK PLACE 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.
CHICAGO, IL 60673-1275
Payee
$124.00
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
S109662300.001 42-389.00 $124.00 I hereby certify that the attached invoice(s),or 1/18/18 S109662300.001 $124.00
2201 2201 2201 2201
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 30,2018
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
.DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER NUMBER CUSTOMER •• NUMBER RELEASE NUMBER TERMS
95776 South Salt Barn PAYABLE ON RECEIPT
SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE
CAMERON CLANTON PK PICK-UP Jim Hobbs FISHERS 317-598-6170 01/18/18
ORDERQTYj SHIPQTY I DESCRIPTION ITEM PRICE UNIT EXT AMOUNT CASH DISC
lea lea AB 400-DP40ND3 124.00 lea 124.00
400 Definite Purpose Contactor,
40A, 120V 50/60Hz, 3 Poles
Billing Questions:Billing_request@kirbyrisk.com(765)446-3054 1/10/2010 siassszaoo_ooi Invoice Number S109662300.001
Subtotal 124.00
S&H Charges 0.00
Invoice is due by 01/18/18. Sales Tax 0.00
Jim x�rns 124.00
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