181555 01/20/2010 i CITY OF CARMEL, INDIANA VENDOR: 117265 Page 1 of 1
e j ONE CIVIC SQUARE G.W. BERKHEIMER CO, INC CHECK AMOUNT: $14.22
CARMEL, INDIANA 46032 Po BOX 1247
:_ti,, PORTAGE IN 46368 -9047 CHECK NUMBER: 181555
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 149007 14.22 MATERIALS SUPPLIES
r 1 85 EkHE,MER 886
CO IN
WHOLESALERS
AIR CONDITIONING HEATING o REFRIGERATION
BRANCH
SOLD TO CITY OF CARMEL 9004 TECHNOLOGY DR.
760 3R0 AVE SW FISHERS IN 460332885
SUITE 110
CARMEL IN 460320000
SHIP TO PLEASE REMIT TO
CUSTOMER "PICKUP P 0 BOX 1247
SHIPMENT# 10- 124685 -01 491 1 PORTAGE IN 463689047
CUST. CODE NO. YOUR ORDER NO. INVOICE NO. INVOICE DATE
21448 10 OPERATIONS FACILITY 149007 1 04 10
QUANTITY
SHIPPED ITEM NO. 1 DESCRIPTION UNIT PRICE TOTAL
2 70339 DP203OA 1003 CONTACTOR 2P 30A EA 1.11 14.11
TAX EXEMPTION CODE: IN 0531101550 NU SALES TAx
28 CASH PAST DUE INVOICE 14.22
DISCOUNT' SUBJECT TO A SERVICE CHARGE AMOUNT
ALLOWABLE IF PAID BY 10TH PROX, NET 11TH ORIGINAL INVOICE
VOUCHER 094105 WARRANT ALLOWED
117265 IN SUM OF$
G W BERKHEIMER
PO BOX 1247 0
PORTAGE, IN 46368
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
149007 01- 6200 -06 $14.22
Voucher Total $14.22
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 199)
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
117265
G W BERKHEIMER Purchase Order No.
PO BOX 1247 Terms
PORTAGE, IN 46368 Due Date 1/12/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/12/2010 149007 $14.22
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