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180900 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 221001 Page 1 of 1 ONE CIVIC SQUARE NEENAH FOUNDRY CORP CHECK AMOUNT: $1,135.16 ri f CARMEL, INDIANA 46032 PO BOX 729 NEENAH WI 54957 CHECK NUMBER: 180900 CHECK DATE: 12/30/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 206 4237001 4236 1,135.16 STORM SEWER MAINT SUP Neenah Foundry NEENAH FOUNDRY INVOICE "Word on the Street is Neenah" Terms: Net 30 Payable in U.S. Dollars FEIN 39- 1580331 Remit To: Neenah Foundry Company Invoice No.: 4236 Box 729 Neenah, WI 54957 Invoice Date: 12/18/09 Phone: 800-558-5075 Fax: 920 -729 -3682 Sold To: Shipped To: CARMEL STREET DEPT CARMEL STREET DEPT 3900 W 131ST STREET 3900 W 131ST STREET WESTFIELD IN 46074 WESTFIELD IN 46074 PAGE 1 Customer Routing Carrier PO No. Job No. Date Shipped C13200 PREPAID USF HOLLAND INC DAVE 25755 12/15/ -09 Qty I Part Number Catalog Description 1 Price Amount 2 39200001 3920 -V SCUPPER P3920 -500 531.00 SET 1,062.00 2 39200007 GRATE P3920 -500 SUB -TOTAL 1,062.00 METAL SURCHARGE: .000 /LB X 518 .00 FREIGHT 73.16 TOTAL 1,135.16 1375 98 1. Claims for errors in weight or number must be made within ten days atter the receipt 01 111e castings 2 Neenah Foundry Co. is not responside for loss 01 or damage lo patterns by Tire 0 other casualties, it shall be the obligation 01 the customer to insure his equipment We do not insure wstomers' patterns 3. Prices do not include sales, use, occupational or simitar tax. It any tax of this nature is imposed on this ale, It is to be pad by the purchaser direally 10 the governmental agency assessing the tax. Any sales, use, occupational, or similar lax imposed on this sale, it unfilled, is the obligation of the purchaser 4. Seller hereby certifies that the above materials were produced in cortlomlity with the Fair Labor Standards Ad of 1938. as amended 5. Limitation o1 damages: under no circumstances will Neenah Foundry Co. be responsible 10 incidental or consequential damages arising born or in connection with the use 01 any Neenah Foundry casting, INVC VOUCHER NO. WARRANT NO. ALLOWED 20 Neenah Foundry IN SUM OF Box 729 Neenah, WI 54957 $1,135.16 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 206 4236 42- 370.01 $1,135.16 I hereby certify that the attached invoice(s), or 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 We.1•sday, December 23, 200 ir Street Commissio Title 7 `'stoner Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No 201 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bili(s)) 12/15/09 4236 $1,135.16 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 20 Clerk- Treasurer