333986 01/04/19 `y`��,q�* CITY OF CARMEL, INDIANA VENDOR: 362073
j/ i, ONE CIVIC SQUARE ANDAX INDUSTRIES, LLC CHECK AMOUNT: $*******272.09*
:9 ,=a CARMEL, INDIANA 46032 613 WEST PALMER STREET CHECK NUMBER: 333986
�'lioN�O' ST MARYS KS 66536 CHECK DATE: -01/04119
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467004 146691 272.09 HAZARDOUS MATERIALS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 362073
IN SUM OF$ CITY OF CARMEL
ANDAX INDUSTRIES, LLC
613 WEST PALMER STREET 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.
ST MARYS, KS 66536
Payee
$272.09
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Terms
Carmel Fire
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
146691 44-670.04 $272.09 1 hereby certify that the attached invoice(s),or 12/18/18 146691 HM Equipment $272.09
1120 102 Prior Year 1120 102
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
Thursday,January 3, 2019
David Haboush
Fire Chief
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
nvoke No Page.a
613 W Palmer Street ---�i-�-•-- •-Y----�---�--
Saint Marys, KS 66536
Tel: (785) 437-0604 �In�o�ce date
Fax: (785) 437-0616 12/18/2018
www.andax.com
Bill To: Ship To:
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
ACCOUNTS PAYABLE CHUCK PLUMER
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
US US
Order NoF Order Date Account NF , a Locw 5alesRep' w a PO Number, E. /COLI
144559 12/17/2018 1004144 4 403 CHUCK PLUMER UPS Prepaid
Quantity ordered "' Qty Shipped/Returned Item No Item pace UOM'Extended Total
_, „ Quantity on back order Descry tion Discount% Lw �pace �f
.1.00 1.00 TTF-100 208.00 EA .208.00
100 GAL TANK TRAP/STORED SIZE
22"D X 4"H
1.00 1.00 GFB-050 54.60 EA 54.60
GRAVITY FLOW BAG/ 50 GAL W/8'
HOSE
Comments: Sales amount: 262.60
Misc./Handling:
Freight: 9.49
Sales tax: 0.00
Subtotal: 272.09
Amount Received: 0.00
!a
PAST DUE INVOICES SUBJECT TO MIN $75.00 COLLECTION FEE PLUS 1.74% ; $otamount dues m 272 09
mo f-_
FINANCE CHARGE PER MONTH
Payment terms: NET 30 DAYS
(0)2003 Ezad Software