183211 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 00352276 Page 1 of 1
ONE CIVIC SQUARE BREAKERS UNLIMITED CHECK AMOUNT: $994.75
i o CARMEL, INDIANA 46032 15241 STONY CREEK WAY
•c,. NOBLESVILLE IN 46060 CHECK NUMBER: 183211
CHECK DATE: 3116/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 511995 102074401 994.75 BREAKERS
BREAKERS UNLIMITED BREAKERS UNLIMITED, CO BREAKERS UNLIMITED, GA BREAKERS UNLIMITED, CA BREAKERS UNLIMITED, TX
TA 15241 Stony Creek Way 5905 Lamar Street 1 Pelly Road, Suite F 5880 District Boulevard, Suite 38 12821 Duncan Road, Suite A
Noblesville, IN 46060 Arvada, CO 80003 y vrenceville, GA 3D443 Bakersfield, GA 93313 Houston, TX 77066
o�� Toll Free:{800j 875 -3294 Toll Free:(8001227.5731 I Freea888J 2378923 f Toll F €ee:(817� 23 ?•8132 Toll 1875-3294
CUSTOMER CODE SHIP l TR I INVOICE NUMBER
CAR700 1020744 -01
317 571 2634
O BILL CARMEL WASTEWATER UTILITIES SHIP CARMEL WWTP
41-
O O 760 THIRD AVE SW SUITE 110 9609 HAZEL DELL PRKWY
l CARMEL IN 46032 INDIANAPOLIS IN 46280
O O
N CUSTOMER P.O. NO. S11995
E E 1Z7 !2
O O
a) SHIP 1 TR I INVOICE NUMBER SLSMN. ORDER DATE TAKER CUSTOMER P.O. NUMBER DATE
v 1020744 -01 100 03/08/10 180 511995 03/08/10 CD 0
L N
0 INSTRUCTIONS FRT. PAGE NO.
—�3
O G P 1 m
3 QUANTITY ter
E 3 ORDERED B.O. I RET. SHIPPED DISP, ITEM CODE AND DESCRIPTION U!M UNIT PRICE AMOUNT (D O
0 Q
1 1 QBL32200 EA 373.75 373.75 O O
N •7V 3P- 200A- 240VAC 3
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2 2 FAL32090 EA 241.50 483.00
O 4- 3P- 90A- 240VAC 3 C
_C CU 2 2 FAL12020 EA 69.00 138.00
O 3 1P- 20A- 120VAC z
L
HANK YOU FOR YOUR PURCHASE CD p
4-- OUR UPS TRACKING NUMBER C1
FOR INVOICE# 1020744 -0001 IS: 41 N
0 V 1Z4324860351914637
3 ACTUAL WEIGHT IS: 20.4
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THIS IS YOUR INVOICE SUBTOTAL 994.75
MISC. CHARGE
FREIGHT IN FREIGHT OUT TE.LE, CHARGE
0. 0 0 0.00 FREIGHT TOTAL 0.00
FED.IOTHER TAX
NET TERMS: INV 30 DUE: 04/07/10 STATE TAX
ORDER COMPLETED PAYMENT REC'D.
Please Remit Payment 7 0: Breakers Unlimited TOTAL AMT DUE
y,. 994.75
15241 Stony Creek Way
Noblesville, IN 46060
L.
VOUCHER 105093 WARRANT ALLOWED
352276 IN SUM OF
BREAKERS UNLIMITED
15241 Stony Creek Way
Noblesville, IN 46060
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
102074401 01- 7200 -03 $994.75
Q I
111
Voucher Total $994.75
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
352276
BREAKERS UNLIMITED Purchase Order No.
15241 Stony Creek Way Terms
Noblesville, IN 46060 Due Date 3/1212010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/12/2010 102074401 $994.75
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