184354 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 00351074 Page 1 of 1
ONE CIVIC SQUARE KIMBALL MIDWEST
i CHECK AMOUNT: $73.95
CARMEL, INDIANA 46032 DEPT L -2780
COLUMBUS OH 43260 -2780 CHECK NUMBER: 184354
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1431423 73.95 OTHER EXPENSES
I
LL I VIVOI C INVOICE NO. F
PLEASE PAY FROM THIS INVOICE 1431423
IT ORIGINAL ORDER NO.
�pr,�ria(+zin� in rlfczieriafs hlanagerr:en: sinr.'e 19 «3 12 4 5 3 3 2 E
.or
REMIT TO: KIMBALL MIDWEST ACCOUNT NO.
DEPT. L -2780
COLUMBUS, OHIO 43260 -2780 (614- 219 -6100) 139903
www.kimballmidwest.com
SOLD TO: SHIP TO:
CITY OF CARMEL SEWER DEPT SEWER DEPARTMENT
760 3RD AVE SW STE 110 730 3RD AVE SW
ATTN LISA
CARMEL IN 46032 CARMEL IN 46032
PAUL
DATE ISALES REPRESENTATIVE PURCHASE ORDER NO, SHIPPED VIA DATE
03/23/10 I COHEN, ROBER AUL U UPS GROUND 03/23/10
ORDERED SHIPPED BALANCE DESCRIPTION UNIT PRICE AMOUNT
DUE
5 5 834613T GLOVES 73.95
To. <he1p us correctly .process), yo r payment please.,:
include invoice number on your remittance advice
hank yo f:or. y r .business Payment is due. 0:4/.2 /10...
I
lease in il' by 0 /7 5/ Q
o recei e invoices via email send a request inc uding you
ccouxit umber 1 invoice @kimbal.lmidwest <Icom
You acknowledge and agree that, by placing this order, all information provided to you by Kimball Midwest herein is confidential and is the property of Midwest
Motor Supply Co., Inc. dlb /a Kimball Midwest. You further agree that this information is for your internal use only and will not be copied, reproduced, distributed
or disclosed by you and /or your organization without the prior written consent from Kimball Midwest.
CARRIERS RECEIPT IN GOOD ORDER CON- ORDERED TAX TAX AMT. SHIPPING INVOICE TOTAL
STIrUTES DELIVERY AND CLAIMS FOR LOSS
OR DAMAGE IN TRANSIT MUST BE FILED BY
CUSTOMER,
GOODS RETURNED WITHOUT OUR CONSENT
WILL POSITIVELY NOT BE ACCEPTED. 73 9 5 73.95
DEBTOR IS LIABLE FOR USUAL AND CUSTOM-
ARY COLLECTION CHARGES.
ALL CHECKS MUST BE MADE PAYABLE ONLY
TO' KIMBALL MIDWEST We Appreciate Your Business PLEASE REMIT THIS AMOUNT
,VOUCHER 105206. VVARRANT ALLOWED
351074 IN SUM OF
Kimball Midwest
DEPT L -2780
COLUMBUS, OH 43260 -2780
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1431423 01- 7200 -02 $73.95
i
Voucher Total $73.95
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
351074
Kimball Midwest Purchase Order No.
DEPT L -2780 Terms
COLUMBUS, OH 43260 -2780 Due Date 4/7/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/7/2010 1431423 $73.95
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