181673 01/20/2010 r a a CITY OF CARMEL, INDIANA VENDOR: 316200 Page 1 of 1
ONE CIVIC SQUARE UTILITY SUPPLY CO INC. CHECK AMOUNT: $15.00
k, �4 CARMEL, INDIANA 46032 6310 S HARDING ST
INDIANAPOLIS IN 46217 CHECK NUMBER: 181673
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 461696 15.00 OTHER EXPENSES
Utility Supply Company
S 6310 South Harding Street www.utilitysupply.com
Indianapolis, Indiana 46217 DATE:° NUMBER
C (317) 783 4196 Fax: (317) 787 -8561 Toll Free: 1- 800 -662 -0829 1311:1.1./ 1.) 4.61 "lt
CA R.:3 00 s INVOICE FED
OL (::1Tl: I•IEL W A TC:F4 1) :L ATE. H WAREHOUSE: W:LI_.L.. CALL.
D 33450 W 13:1ST sT'FiIEF:
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TAX JURISDICTION NO. DESCRIPTION TAX EXEMPT
(31 7) 73.3-2855 5 0001 1:1 Ail() 00031 201550 :L0
LOC. DATE ORDERED DATE SHIPPED' SHIP VIA, JOB. NO _CUST:.ORDER NO SALESPERSON cLK TERMS' COPY PAGE
>.13()i./07 /1001 '7 /1OW:EL..I.. CALL 1.7 5:L1IE:T 3(:) DAY )101
ORDERED 3'• e
SHI �r= DESCRIPTION�+��:.
BACK ORDERED
1. 1.( (t)' I.( (44 /'4` ..031 4f:' 4+,. r...(
EA. INSERT FOR PE
Lx' 20. 0 20. (?)C) .1 PI...AST:CC: INSERT PI::: 54 1 (%1.. 6)(J
?)C') 1.5. 00
SALES AMOUNT SALES TAX SHIPPING CHG. CODE DEPOSIT CASH CODE
PLEASE AMOUNT
A FINANCE CHARGE computed at a periodic rate of 1'h% per mooth (18% ANNUAL
PERCENTAGE RATE)'is applied to DUE ACCOUNTS: OVER 30 DAYS.
RECEIVED BY
VOUCHER 094111 WARRANT ALLOWED
316200,x,. IN SUM OF
Utility Supply Company
6310 South Harding Street
Indianapolis, IN 46217
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
F�O INV ACCT AMOUNT i Audit Trail Code
461696 01- 6200 -06 $15.00
Voucher Total $15.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
316200
Utility Supply Company Purchase Order No.
6310 South Harding Street Terms
Indianapolis, IN 46217 Due Date 1/12/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/12/2010 461696 $15.00
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
Date Officer