327911 07/20/18 (9)
CITY OF CARMEL, INDIANA VENDOR: 00351747
ONE CIVIC SQUARE TRI STATE BEARING CO INC CHECKAMOUNT: $*********6.16*
CARMEL, INDIANA 46032 PO BOX 4737 CHECK NUMBER: 327911
EVANSVILLE IN 47724-0737 CHECK DATE: 07/20/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 103537200 6.16 OTHER EXPENSES
VOUCHER NO. 185968 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No. 201(Rev 1995)
Vendor # 351747 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
TRI-STATE BEARING CO., INC. CITY OF CARMEL
P.O. BOX 4737 An invoice or bill to be properly itemized must show: kind'of service,where performed,
EVANSVILLE, IN 47724-0737 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
6.16 351747 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR TRI-STATE BEARING CO.,INC. Terms
Carmel Wasterwater Utility P.O. BOX 4737 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice EVANSVILLE, IN 47724-0737
(s),
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
1035372-00 01-7202-06 $6.16 and received except 7/10/2018 1035372-00 $6.16
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_
Clerk-Treasurer
TRI-STATE BEARING CO., INC. INVOICE
Initiating Warehouse
III I I II II I II II I I II(III I II II I II I II II II III 2Ind
Indianapolis, 46218c
Phone: 317-924-3287 Fax: 317-924-3561Number"; 1035372-00
Remit ToDate 06/25/18
PO Box 4737
Evansville, IN 47724-0737 Page:. 1
P: 812-425-1336
F:812-421-6788
Phone:812-425-1336 Fax:812-421-6788
BillTo = Carmel Wastewater Treatment ShtP,To, '" Carmel Wastewater Treatment
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
7927 Indianapolis,IN 46280-2935 Indianapolis,IN 46280-2935
OrderrTaker Ordered Shipped Slsp Terms' IVh Shtp,".1%ia
BKM 06/21/18 06/21/18 ZI Net 30 07 Pick Up
lnstracbons --_ Caller,
S18583 DUANE
Ln Product Quantity Quantity s Quantity Unit Price Amount
And Description Ordered Shipped` Backordered U101, Price UM /lVet1
1 SKF17X30X7DL ' - 2 2 0 EA 3.08 EA ,6.16
SEAL;METRIC[6622][692685]
1 Lines Tota/ Qty Shipped Total 2 Total 6.16
Invoice Total 6.16
Cash Discount 0.00 If Paid By 06/25/18
Print Time: 06/25/18 19:24* Customer Copy Page 1 of 1
TRI-STATE BEARING PICK TICKET/PACKING LIST
II I I I II II LII II I I II IIII I II II 111 I II II II III -22ndianapEnterprise Initiating IN 4621rehouse 1
i8Ce --
Phone: 317-924-3287 Fax: 317-924-3561 Number 1035372-00
** DO NOT PAY **** DO NOT PAY **** DO NOT PAY ** Date 06/21/18
Page 1 _j
Ship To Carmel Wastewater Treatment Bill To Carmel Wastewater Treatment
.9609 Hazel Dell Pkwy 7927 9609 Hazel Dell Pkwy
Indianapolis,IN 46280-2935 Indianapolis,IN 46280-2935
OrderTaker- Ordered Shipped Slsp Terms Wh Ship Via
BKM 06/21/18 06/21/18 ZI Net 30 07 Pick Up
PO# Instructions Caller
S18583 DUANE
Line Product Quantity Quantity Quantity Qty Bin Unit Amount
# And Description Ordered Shipped Backordered UM Location Amount ' (Net)
i
1 SKF 17X30X7DL 2.00 2.00 0.00 EA ER5 3.08 6.16
SEAL;METRIC
[6622][692685]
Total 6.16
1 Lines Total ** #of Lines Not Printed 0 Qty Shipped Total 2.00 Total
Picked By Packed By Checked By Cube Weight Freight Charges Total Net(less tax and freight)
0.00000 0.04800
Received By Date Received
Print Time: 06/21/18 08:02* Customer Copy Page 1 of 1