184305 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 00351010 Page 1 of 1
ONE CIVIC SQUARE HALSEN PRODUCTS
CARMEL, INDIANA 46032 PO BOX 877 CHECK AMOUNT: $210.26
BELMONTMS 38827 CHECK NUMBER: 184305
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232100 0106160 -IN 210.26 GARAGE MOTOR SUPPIE
INVOICE PAGE-
HALSEN PRODUCTS COMPANY
1
RO BOX 877
BELMONT, @r1S 38827
NATIOWDE t e0o3a9 669s INVOICE NUMBER: 010 616 0 I N
FAX f 8 826 8839 INVOICE DATE: 3 /2 6/2 010
ORDER NUMBER:
ORDER DATE:
SALESPERSON:0523
CUSTOMER NO: 0 2 3 0 3 2 7
SOLD TO SHIP TO
CITY OF CARMEL STREET DEPARTMENT
ACCOUNTS PAYABLE DEPT BONNIE CALLAHAN
3400 W 131ST ST 3400 WEST 131 STREET
Westfield, IN 46074 Westfield, IN 46074
CONFIRM-TO:
BONNIE
CUSTOMER PO SHIP ?VIA ..7E S
BONNIE UPS Net 30
i t M
NO S UNIT x
SNIPPED;" B'ACI( QRDER PRICE' AMOUNT,
EACH 2 0 95.500 191.00
SCRUBS IN A BUCK 1,T 6 /CA E
N.e -t —I nv o.i ce.: 191.00
=L t ess, 'Discoun 0.00
THANK YOU FOR YOUR ORDER Freight!: 19.26
Sales. Tax: 0.00
Ihvoice Total:' 210.26
Less ,Deposit:` 0.00
INVOICE $ALANGl;'
1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Halsen Products
IN SUM OF
P. O. Box 877
Belmont, MS 38827
$210.26
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# I Dept. INVOICE NO. ACCT #TTITLE AMOUNT Board Members
2201 0106160 -IN 42- 321.00 $210.26 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Moriday4 it 05, 2010
Street Commission
reel nissioner
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
03/26/10 0106160 -IN $210.26
1 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
20
Clerk- Treasurer