182444 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 00350691 Page 1 of 1
ONE CIVIC SQUARE MACHINE DRIVE COMPANY
CARMEL, INDIANA 46032 PO BOX 569 CHECK AMOUNT: $495.00
AKRON OH 44309
CHECK NUMBER: 182444
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 F96288001 495.00 OTHER EXPENSES
01/28/10 07:24 PR EST BN Rogers Co. via VSI -FAX Page 1 of 1 #203515 Id-
INVOICE
MA R T0: ENTERING OFFICE INVOICE NUMBER TRAN
MACHINE DR E 6 W ROGERS CO CODE
I�i
MACHINE DRIVE DIV F96288 -001 DI
C 0 M P A N Y 15402 STONY CREEK WAY INVOICE DATE PAGE
P.O. Box 569 Akron, Ohio 44309 NOBLESVILLE IN 46060 01/28110 1
For Terms and Conditions visit: www.bwrogers.com Any different or additional terms that may be embodied in your purchase order are hereby objected to. It your order is not an
acceptance ct our proposal, this wilk operate as an acceptance of your order only in the event you agree to the terms hereof.
The terms and conditions contained above and attached shalt apply.
-::$1>< PI41 >::G:; 4:::
:•:.TCYflltk ::•:...:::.::.BAS;:;:•:• <7rF�l:;•:•:•::•::•:•::•: a
S i =i; >cpl tJ 4 F. ....NViQFiMf.
R D........
91 1 1 CIMR- P7U47P5 /REPAIR 495.0000 495.00
REPAIR Y07D EA
20 SN# 1W0517537870008
INBOUND FRT IS: .00
FOLD
COST, NO. ORDER DATE TERR PC ORD Written By DATE SHIPPED WHSE AMOUNT 495.00
C4037 01/25/10 8C 08 S KEB 01/28/10 08 FRGHTlINSIHNDL 00
Carrier: WILL CALL FOB: SP,FNA,PREPAID ORIG FAX INVOICE
SALES TAX 00
Tracking:
TermsotPayment: NET 30 DAYS CUST FAX 317- 571 -2462 INVOICE TOTAL 495.00
Please Pay This Amount
ORDER ISSUED IN: NOBLESVILLE
PHONE: 317- 776 -2900
Customer PO No. S1 1952 Mark No.
s CITY OF CARMEL UTILITIES s CITY OF CARMEL UTILITIES
O ATTN A/P H WASTEWATER
0 760 THIRD AVE SW P 9609 HAZEL DELL PARKWAY
T CARMEL IN 46032 T INDIANAPOLIS IN 46280
0 0
VOUCHER 097303 WARRANT ALLOWED
;350691 IN SUM OF
MACHINE DRIVE COMPANY
PO BOX 569
AKRON, OH 44309
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members.
PO INV ACCT //A Audit Trail Code
F96288001 01- 7362 -06 $495.00.
Voucher Total $495.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 241 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL 0
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
350691
MACHINE DRIVE COMPANY Purchase Order No.
PO BOX 569 Terms
AKRON, OH 44309 Due Date 2/9/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/9/2010 F96288001 $495.00
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
1
(f
Date Officer