182552 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 00351427 Page 1 of 1
z ONE CIVIC SQUARE STATE INDUSTRIAL PRODUCTS CHECK AMOUNT: $1,381.64
CARMEL, INDIANA 46032 PO BOX 74189
CLEVELAND OH 44194 CHECK NUMBER: 182552
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 94488964 1,381.64 OTHER EXPENSES
t Invoice PAGE: 1
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♦ate World Headquarters
3100 Hamilton Avenue 94488964 01/25/2010 02109/2010
61 nca 1977 Cleveland, Ohio 44114 If you would like to receive your invoice via fax, please
800 782-2436 contact our Customer Service Department.
State Chemical is a Division of State Industrial Products Your Fax number on file is: 317- 571 -2265
Our Customer Service Phone number is: 1 -800- 782 -2436
03289020 .29203 -C- 56643982.0357 3i3 Shi -To No.: 518113
Customer No.: 490452
CARMEL SEWER DEPARTMEN CARMEL SEWER DEPT
ATTN: ACCOUNTS PAYABLE FA
760 3RD AVENUE SW STE #110 901 N RANGELINE RD ISO 9oo7
CARMEL IN 46032
CARMEL, IN 46032 I OMI.SAI G1.6.1
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Customer P.O.: paul arnone Sales Order: 3676899 Delivery: 800395169
Your Account Manager: 90148622 MICHAEL WELSH Taxable: N
:?3niL
2:..Y CIf_1�.. i .Y f item:.;`:.:: fJt q,ri tlorl..... €?rtee ?nGe,
0 4 4 EA 108794 S STATE PIT Ress 246.000 984.00
0 2 2 BC 123175 P RIMEZYME D51D19 175.000 350.00
1. IMPORTANT: Please return remittance portion
of invoice with your payment. To assure proper
credit to your account, ALWAYS include your Net sales Shi in &f?Focessin Sales Tax?:: TOTAL?
customer number, invoice number, and amount
paid with your remittance. 1334.00 47.64 0.00 1,381.64
2. All shipments FOB nearest warehouse.
3. Claims for shortage or damaged goods must be We hereby certify that these goods were produced in compliance with
made within 5 days after receipt of goods. all applicable requirements of Section 6, 7 and 12 of the Fair Labor
4. No returns without written authorization. Standards Act as amended, and of regulations and orders of the United
5. If you have any questions regarding this States Department of Labor issued under Section 14 thereof.
invoice please contact us at 1 -800- 782 -2436.
PAY NO MONEY TO AGENTS FOR CHEMICAL EMERGENCY SPILL,
LEAK, FIRE, EXPOSURE OR ACCIDENT
FED, TAX I.D. NO.
All tax exempt customers CALL CHEMTREC DAY OR NIGHT
34- 0552740 must submit tax exempt 18001 424 -9300
certificate with payment.
VOUCHER 097250 WARRANT ALLOWED
J.
351427 IN SUM OF
STATE INDUSTRIAL PRODUCTS /US E
P.O. BOX 74189
CLEVELAND, OH 44194
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
94488964 01- 7200 -02 $1,334.00
94488964 01- 7200 -02 $47.64
ICJ
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1 4�
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Voucher Total $1,381.64
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
351427
STATE IND USTRIAL PRODUCTS /US ENGINEE Purchase Order No.
P.O. BOX 74189 Terms
CLEVELAND, OH 44194 Due Date 2/8/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/8/2010 94488964 $1,381.64
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
Z A1110
Date Officer