184686 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 00352276 Page 1 of 1
ONE CIVIC SQUARE BREAKERS UNLIMITED CHECK AMOUNT: $852.15
CARMEL, INDIANA 46032 15241 STONY CREEK WAY
NOBLESVILLE IN 46060 CHECK NUMBER: 184686
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 S12131 209860501 852.15 BREAKERS
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BREAKERS UNLIMITED BREAKERS UNLIMITED, CO BREAKERS UNLIMITED, GA BREAKERS UNLIMITED, CA BREAKERS UNLIMITED, TX
15241 Stony Creek Way 5905 Lamar Street 100 Petty Road, Suite F 5880 District Boulevard, Suite 18 12821 Duncan Road, Suite A
Noblesville, IN 46060 Arvada, CO 84003 Lawrenceville, GA 30043 Bakersfield, CA 93313 Houston, TX 77066
a Toll Free:(800) 875.3294 Toll Free:l800) 227.5731 Toll Free:(688) 237 -6923 Toll Free:(877) 232 -8732 Toll Free: (800) 875 -3294
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CUSTOMER CODE SHIP I TR 1 INVOICE NUMBER
CAR700 2098605 -01
317 571 2634
O BILL SHIP
70. TO. CARMEL WASTEWATER UTILITIES CARMEL WWTP CC
as 0 760 THIRD AVE SW SUITE 110 9609 HAZEL DELL PRKWY C
O CARMEL IN 46032 INDIANAPOLIS IN 46280 O
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SHIP 1 TR I INVOICE NUMBER SLSMN. ORDER DATE TAKER CUSTOMER P.O. NUMBER DATE
v Y 2098605 -01 100 04/12/10 151 512131 04/13/10 0
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O INSTRUCTIONS FRT. PAGE NO.
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({f '3 QUANTITY
E ORDERED B.O. RET. SHIPPED DISP. ITEM CODE AND DESCRIPTION UIM UNIT PRICE AMOUNT ro 0
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1 1 QBL32100 EA 373.75 373.75 O O
E 3P- 100A- 240VAC c
2 2 FAL32030 EA 170.20 340.40
j 3P- 30A- 240VAC rr
16- 2 2 FAL12020 EA 69.00 138.00 =r CD
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3 THANK YOU FOR YOUR PURCHASE CD
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YOUR UPS TRACKING NUMBER I n'
E FOR INVOICE# 2098605 -0001 IS: ly N
j„ IZ4324860352192988
O CTUAL WEIGHT IS: 19.3 0
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THIS IS YOUR INVOICE SUBTOTAL 852.15
MISC. CHARGE
FREIGHT IN FREIGHT OUT TELE. CHARGE
0.00 0.00 FREIGHTTOTAL 0.00
FEDJOTHER TAX
NET TERMS: INV 30 DUE: 05/13/10 STATE TAX
ORDER COMPLETED PAYMENTREC'D. 0.00
Please Remit Payment TO: Breakers Unlimited TOTAL AMT DUE
15241 Stony Creek Way 852.15
Noblesville, IN 46060
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VOUCHER 105298 `'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
209860501 01- 7200 -03 $852.15
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Voucher Total $852.15
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 4/19/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/19/2010 209860501 $852.15
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
11 2 3/
Date Officer