HomeMy WebLinkAbout334477 01/18/19 ,_�,q" CITY OF CARMEL, INDIANA VENDOR: 371822
j;® ONE CIVIC SQUARE MEDORA CORPORATION CHECK AMOUNT: $*****3,170.00*
s �10 CARMEL, INDIANA 46032 3225 HWY 22 CHECK NUMBER: 334417
;TON�°? DICKINSON ND 58601 CHECK DATE: 01/18/19
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT IDESCRIPTION
651 5023990 80318 3,170.00 OTHER EXPENSES
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VOUCHER NO. 187144 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor # 371822 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
MEDORA CORPORATION CITY OF CARMEL
3225 HIGHWAY 22 An invoice or bill to be properly itemized must show: kind of service,where performed,
DICKINSON, ND 58601-9419 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
$3,170.00 371822 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR MEDORA CORPORATION Terms
Carmel Wasterwater Utility 3225 HIGHWAY 22 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice DICKINSON, ND 58601-9419
(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
80318 02-2308-00 $3,170.00 and received except 12/30/2018 80318 $3,170.00
Depreciation
1
1 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
l[GridBee
Remit To:. Invoice
Medora Corporation
3225 Hwy 22
Dickinson ND 58601-9419 Invoice #: 80318
701-225-4495 Date: 18 Dec 2018
Customer#: CAR14
Bill To: Carmel Utilities Ship To:Carmel Utilities
9609 Hazel Dell Pkwy Attn:Duane Jarvis
Indianapolis IN 46280 9609 Hazel Dell Pkwy
United-States Indianapolis IN 46280
United States
Purchase of test machine
— -- - - Terms - --- -- --- -- - --- Ship Via:- - - -- -- - -.Net 30 Days P.O. Number: S18750
Qty. Shipped Item Number
Qty..B/O Item Description T/N Unit Price (USD) Ext. Price (USD)
1.00 *AP SERIES (500) N $ 2,680.0000 2,980.00
Air Powered Mixing System
Notes:
GridBee Model AP500-AU200; S/N 160204331
This invoice is for the purchase of the test machine.
Received by
cct #: as- co
964A
Subtotal: $ 2,980.00
Freight: $ 190.00
Sales ax: $ 0.00
Total Due: $ 3,1.70.00
Page 1
][Gridfteu
PACKING List
Shipment#: 4458
II�II�II
S/O #: 54662 II II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
Customer #: CAR14 IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIII
Customer P/O #: S18750 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
Order Date: 07 Aug 2018
Sched. Date: 07 Aug 2018 Ship Via:
Bill To: Carmel Utilities Ship To: Carmel Utilities
9609 Hazel Dell Pkwy Attn:Duane Jarvis
Indianapolis IN 46280 9609 Hazel Dell Pkwy
United States Indianapolis IN 46280
United States
Attention: CAR14 Terms: Net 30 Days
Order Line Item Number UOM Ordered Shipped Verified
Item Description
1 *OTHER EA 1.00 1.00 Status: 0
ADDITIONAL ITEM IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII
Notes: GridBee Model AP500-AU200 Mixer S/N 160204331
(Pilot Test Rental for 30 days)
I
Completed Bye Checked By:
Print Date: 07 Aug 2018 Sales Order#: 54662 Page:1