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Home My WebLink About185235 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 088550 Page 1 of 1 ONE CIVIC SQUARE EVERETT J PRESCOTT INC CHECK AMOUNT: $799.39 4 f CARMEL, INDIANA 46032 PO box 350002 BOSTON MA 02241 -0002 CHECK NUMBER: 185235 CHECK DATE: 5/11/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 4217936 686.87 OTHER EXPENSES 601 5023990 4241549 112.52 OTHER EXPENSES Pipeline Specialists EVERETT J. PRESCOTT, INC. O HM19 0 SEE CONDITIONS OF SALE AND HOME OFFICE J� °PCG� PAYMENT TERMS ON REVERSE, 32 PRESCOTT STREET T "'P° J ,.j J I P.O. BOX soo GARDINER, MAINE 04345 METER BACKFLOW SERVICES Po. Box soo Everett J. Prescott, Inc. TELEPHONE (207) 582 -1851 21O SHEEP DAMS ROAD, CONCORD, NH 0330f Gardiner. ME 04345 `h 1 ..3 F 603 224 -8." FAX ,5 224 -311 (207} 582 -5019 FAX (2o7J 582 -9118 INVOICE DATE r i r.•.:5 f 1. REMIT WAREHOUSE T'I= t JP !.V» 1171d:i a11,aPC,11 J. s TEAIYI I"'. -.+P W1 IT i,71T _;F:-01. i S PACKING SLIP NO.; 4 1.,- A9 TO> E J,. PRE CJ77 1NC 1330 W. Wmis l'i i't +1 �1 3n. S L CUSTOMER NO. 4 P I_) F3 l_ x 21,51 1C,f72 1 220 WAREHOUSE., 0224 -0502 Te :L c; I"' I !IaFi s— 31 7-- 247 -0005 ORIGINAL INVOICE SOLD TO> (_:.ET y 1 0 C,( H3C •ic: I {�F 1`I :1 F :I:'i'� SHIP TO> I -i Y OF' 'Ct WA'TER D I.S -450 W. 1,31st Street 3450 W. 121st Street ["Jestf 1"N Westfield, 1N 46()71 60 CUSTOMER P.O. NO. JOB NAME JOB NO. SLS. DATE DUE DATE SHIPPED -:SHIPPING METHOD I,I(J :_12:1. 06 IF 3.1i ilJ 4,'23 E'ti.31' 1 f'isi.:l Im m p I l l ''"i i .L 47 r r 1 a f 3 2 i:.- r I•� l� 1: �.t =.t� ?�1I'! 1. t)(J �C� f�:{ {i: r I�ty .:.3• r_= 1W�.:i..:l�y -1 o 1 YOU F "OR YOUR RUS..�.:I ,i .SS! WE P IRE D01MG AL-L WE CAN THANKYOU AMOUNT f 5=' I•C! r iylwEP `r=/ I'R :I:i4I i r6 Lis UNICER- 1'A:?N ECEINOMV. FOR YOUR BUSINESS! TAX e: clo 00 tsi�`>� 1=��'`Y3 1 \1T u �It..,•12 !!EL P 3� FREIGHT �C' I E, I= RICES ARE 1 ASE:D i:_�! i PLEASE !VOTE: OUR TERMS NEE DED D A! xl) A1 D 011= 1_0'r C= I S TE,')1 E:..I F ARE NET 30 DAYS. YOUR O t h e it 0 SERVICE CHARGE IS 1 PER MONTH (18% A.P.R.) ON THE BALANCE OVER 30 DAYS OF AGE. THE BUYER HELP IS NEEDED AND AGREES TO PAY ALL COSTS AND EXPENSES OF COLLECTION, INCLUQING REASONABLE ATTORNEY'S FEES, AND EJP CLAIMS A MECHANIC'S LIEN UNDER APPLICABLE STATE LAW. APPRECIATED. v E.J. [Pre scott, Inc. Terms and Conditions of Sale Prices: All prices are subject to change without notice, except where turn quotations have been provided in writing by authorized managemenl personnel of LIP Traces: Prices do not include, any present Or future federal. state, or local taXCS inchtding, svitht:rut sates tax, use tax, excise iat or otherwise) unless specifically stated. It is the responsibility of the Buyer to pay all such tares. T'axcs where applicable tnav be added to the price Of the products and AhalI be paid by the Buyer. unless the I3ttye1 furnishes to EJP a tax exemption certilkate in a form agreeable to the applicable taxing authorities. if F,JP is requirCd to prepay any such tax. Buyer will reimburse EJP in full upon demand. Pnyment Terms: EJP Open Credit accounts are established for commercial. non consumer use Only. Unless an approved commercial Open Credit aCOUrt is established. payment in good funds or approved check must be made before or at time of defivery. Commercial Credit terms are Net 30 days, no cash discounts allowed. Service Charges commence after 30 days and are calculated on the last day of the month in which the 30th day falls. SER- VICE CHARGE PER NIONTi r lM A.RR.) ON "rHF BALANCE OVER 30 DAYS OF AGE.,. THE BUYER. AGREES TO PAY ALL COSTS AND EXPENSES OF COLLECTION. INCLUDING, RLASONABLE.NFFORNEY S F L'ES, and EJP claims a mechanic's hen under applicable state law. Acceptance by EJP: All orders horn the Buver are subject to acceptance by authorized personnel of EJP. and, in the case off Open Account Stiles. approval of the EJP Credit Department. Cancellations: SPECIAL OR NON- STOCK ,'ITENIS MAY NOT BE CANCELLED OR RETURNED AFTER THE PRO'DU'CT(S) IS PLACED INTO PRODUCTION. All charges and costs incurred by EJP as a result Of cancellations ur order chan-es will be billed to the; Buyer. Delivery: FiP will make a good faith effort to complete delivery of the products; provided, however, that EJP assumes no responsibility or liability Cot loss Or damage dUC to delay ur inability to del iver, if such non- perfomtance was tare result of any Cvents or circumstances beyond the control of EJP, inchtd- ing, but not limited to. acts of God, war, labor difficultte-s, tire, accidents, inability to obtain materials, std delays of carriers, contractors,suppdiors. or Inanufacturerv, Under no circumstances' shall EJ�P'be liable for arty Special. coo equential. incidental, indirect, or liquidated dantal es los es, or expense (whether or not based on negligence) arising directly or indirectly front delays or failure to give notice of delay. Shipment: Shipment' Of all products is to one given'destinalion for all items includiu; pipe, unless otherwise indictrted in writing. Risk ofloss-hall trans- fer to the Bever upon tender of goodl; to Buyer, Buyer's representative, or common carrier. The cost of any special pocking or special handling caused by Buyer's requirements or requests shall be added to the amount of the order. If Buyer causes or requests a shipment delay. or if EJP ships or delivers the products erroneously as a result of inaccurate, incomptetc or misleading information supplied by Buyer or its agents or emptoyseS, storage and all other additional costs and risks shall be borne solel by Buyer. Claims for products damaged or lost in transit should be made by J3uyer to the currier, as EJP's responsibility ceases upon tender of good-S to ,Buyer, Buyer's representative or common carrier. Delivery will be made on hand surfaces only. Any dam- age or towing change" resulting from "non hard surface deliveries `.hall be the responsibility of the Buyer. Inspection and Acceptance: Claims for damage, shortage or erars in shipping must be repmied within 10 day; following delivery to Buyer. Buyer shall have 10 clay; from the date Buyer receives .irty products to inspect such products and services for defects and nonconformance and notifv EJP, in writing;, Of any defects. nonconformance or rejection of such products: After such 10 day period, Buyer shall be deemed to have irrevocably accepted the prod uctS. if not previously accepted. After such acceptance, Buver,shal l have no right to reject the product, for any reason or to revoke accept a rice. Buyer here- by agrces that such 1.0 clay period is a reasonable amount of time for such inspection and revocation. Returns: Materials cannot be returned Without FJP'S written consent, NO RETURNS ARE AI.I...OWED AND NO REFUNDS WILL BE MADE ON lit PIPE OR (ii) SPECTALLY FABRICATED OR ORDERED ITEMS. THE SOLE AND EXCLUSIVE REMEDY FOR SUCH ITEiv -IS ALLEGED TO BE DEFECTIVE IN WORKMAN`HIPOR MATERIAL WILL BE THE REPLACEMENT OF THE ITFNIS SUBJECT TO THE MANUFACTURER'S INSPEC- TION AIND WARRANTY. All Other returned material is subject to a MINIYIUM 25r RE-HANDLING CHARGE, plus transpomitioa charges. Unless other- wise a reed by the Buyer and F-M. all credit for returned material will be applied to future; orders. Su to approval by the EJP Credit Department. Warranty. 1 1'1IE BUYER'S SOLE AND EXCLUSIVE WARRANTY, IFANY, Is TI -IAT PROVIDED BYTHE PRODUCTS i1MANUFACTURER. EJP MAKES NO EXPRESS OR IMPLIED WARRANTIES. EJP HEREBY DiSCLAIMS ALL EXPRESS OR JtIMPLI.ED WARRAti FIFS. WHETHER IMPLIED BY OPERATION OF LAW OR OTHERWISE, INCLUDING, WITHOUT LINNUTATION, At-I., JMPI.I.FF) WARRANTIES OF MERCHANTABILITY AND ErFNESS OR 'FITNESS iT ;NIESS FOR A. PART'.ICLILAR PURPOSE:. UNDER NO CJRCUMSTANCES, AND IN N0 EVENT.'. WILL L EJP BE LIABi.,E FOR PERSONAL. INJURY OR PROPERTY DAMAGE OR ANY OTHER LOSS, DAMAGE. COST OR REPAIRS OR INC[- DENTAL. PUNITIVE, SPECi L, C.ONSEQUEN "T]AL OR LIQUIDATED DA,NIAGES OF ANY KIND, WHETHER BASED UPON yVARRA_NTY, CONTRACT, STRICT LIABILITY, NEGLIGENC ;E OR'ANY OTHER CAUSE OF ACTION ARISING; IN CONNECTION' WITH THE DESIGN, MANUFAC'T'URE. SALE, TRANSPCIRTATION, iNSTALL.NFION. OR REPA[R OF T I IF, PRODUCTS SOLD 13Y EJP. BUYER ACKNOWLEDGES AND AGREES THAT UNDER NO CIRCUMSTANCES, AND IN NO EVENT. SHALL EJI?'S LIABILITY. IF ANY .'EXCEED THE NET SALES PRICE OF TH.E DEFECTIVE PR.ODUCT(S i. hattire Agreement This document constit utes the entire.; complete, and exclusive ag3e+eme.nt between the parties with respect to the subject matter here- of rind contains all the agreements and'MrlditionS Of sale; no course of dealing or us.tge of the trade shall be applicable unless expressly incorporated here- in. The tennis and conditions contained herein may not be added to. modified, superseded or otherwise altered except by a written modification signed by authorized management pe.r ;onuia of EJP All transactions shall be governod solely by the leans and conditions contained herein. All purchase orders issued pursuant to an EJP quotation shall be deemed issued subject to all EJP teens and conditions herein contained. 'Theno tents and c;ondifions shall supersede dirgc of file Buyer. Governing Law: T'ltis transaction Shall be governed in all respects by the laws of the State of Maine (excluding choice of law provisions). All actions, rc9ardless of form, arising out of or in connection with this Ilansac tion, the products sold by EJP, or the relationship Between the Buyer and EJP shalt bo brought in the coons of the State of Maine within the applicable Stahnory period. c C.ommunieations: Payments only should be directed to: E,.1. Prescott, Inc., 1 Box 350002. Boston. MA 2241 -0502. All other correspondence and inquiries Ahould be directed to your local EJP Division. The Hume Office address is 3? Prescott Street. P.O- Box 6(10, Gardiner. Maine 04345. Telephai u (207) 582 -1 K5 1. Fax (207) 552- 5637. E -mail e1 }Xme_iprescon.com. E,;P TSC Rtli;,Aoll (late 4,09 Pipeline Specialists EVERETTJ. PRESCOTT INC. p6M SEE CONDITIONS OF SALE AND HOMFFICE o I��[7 PAYMENT TERMS ON REVERSE. I E�) 32 PHOM O E O STREET F ST p� P.O. BOX 600 GARDINER, MAINE 04345 METER BACKFLOW SERVICES P.O. Bo: soo 210 SHEEP DAVIS ROAD, CONCORD, NH 03301 Gardiner, ME 04345 11RiCA= d1,`R� ;R -1 J 9;'�! p'y Everett J. Prescott, Inc. TELEPHONE (207) 582 1851 603 224 -8425 FAX 603) 224 -3642 12071582 -5019 FAX 12071 582 -9118 INVOICE DATE I i •I REMIT TE:=.I° -11'1 1-_JF 1, i7'i d :!.anx11:1o.L1s WAREHOUSE�;r 1:_.JP 1 ln +poll PAGKiNGSLIPNO' S9 r TO c r r 1 'S; 1 GUSTOMER NO. .3 7 V1 W %_i .J 1 T i t I i i s y 0 F3 0 X 3 5 i.: WAREHOUSE, 220 k.�(3 rokl, MA i i s r I1I1 6 2 :31 02241- Tea el :,hone e ;31.�?`- 24 Of)+.7:`.i ORIGINAL INVOICE SOLD TO> r...11 "Y DF= C()RM 1 ,...�--t�df- TE h� E 1.:�ST SWIPTO l` ::1. FY !,)F= Ci"iRf 11` 3 W. 1 c I, P•ee;1' 3 W 121s sa�..� lfl 1_. tr 1, •I J. e y .I N ICIes 1. .I.. e 1. -11 y .�.1w CUSTOMER P.O. NO. JOB NAME JOB NO. SLS DATE DOE.: DATE SHIPPED SHIPPING METHOD i_I; (J,�, 1 13 ;3 ?lll: 1 L3 tar 'Tr 1. 5 0324 s 11 X U BATTERY P( -)CK 505B EA 30 17 .83000 534 n o 5C) 1 22 3 /4 FBI I BOT7011 PL -A'FE T RON1 E," 7 7.60 53 .20 9 C 7 `i w 0771..11'1 F�I_.'H' I l._1.. 1`• ER i Fa .�i�FV��C� 1.6. 3/4 t`� 7 1 6 11 1 5 `+0h: ?t7 i/ 3 11� 1 °Iw:R 1i L7 "f'TOh1 L_I1'tEl EIr`+ 1 1 .4 �if:tCi 1 „20 6 Z, 3 5/8 SR 11 1 2, DT' 1 0M PL€ I 1=_ PLASTIC IMA 1 6.00()- O 60 u 00 !110 ql(:) 16 51. ri i 3/4 BRII RE:G t'DrI 10010: READ EA 0 2B.. 13000 v00 a TI- 192,P YOU FOR YOUR 1•_4tJ;-S1'NE S S WE PiRE: L31 AL_L. WE CON THANK YOU AMOUNT E� 7 T O IV1=;EP PRIC'•km`•:1 FAIR 1N TI-11 C1N%C 14 r1`11.N I= :i.'01,41111y1Y. FOR YOUR BUSINESS! TAX Y PRT- CE-S ARE B; -i;r_, :D1 101\1 30 DAY PAYMEN'T. YOUR HELP 1,9- PLEASE NOTE: OUR TERMS FREIGHT 0 r, .E Dj= Q AMD -i r. A _1 I ARE NET 30 DAYS. YOUR 4 SERVICE CHARGE IS 1'h% PER MONTH (18% A.P.R.) ON THE BALANCE OVER 30 DAYS OF AGE. THE BUYER HELP IS NEEDED AND ll a l AGREES TO PAY ALL COSTS AND EXPENSES OF COLLECTION, INCLUDING REASONABLE ATTORNEY'S FEES, 999 6 8 6) G 7 AND EJP CLAIMS A MECHANIC'S LIEN UNDER APPLICABLE STATE LAW. APPRECIATED. E.J. Prescott, Inc. Terms and Conditions of Sale Prices: All prices are subject to change without natice. except Where furls gi€otations have been provided in writing by authorized anan tgementpersonnel of ETR Taxes: Prices do not include ally present crr'fuu€re federal. state, or local taxes (including, without limitation, sales lw<x use tax, excise tiix, or otherwise) unless Specifically stated. It ig the responsibility ofthe Buyer to pay all such taxo Taxes where ;applicable may be added to the price (it products and shall tic paid by the Buyer. unless the Buyer furnishes to EJP a lax exemption certificate in a form a-recable to the applicable taxing audwrities. If EJP is required to prepay any such tax, Buyer will reimburso EJP in full upon demand. Paynlent'Ierms EJP Open Credit accounts are established for commercial, non consumer rise only. Unless an approved coniniercial Opea Credit account is established. payment in good funds or approved check must be made• before or at time of delivery. Connnarcial Credit terms are Net 30 days, no cash discounts allowed. Service Charges commence after 38 flays and are calculated on the last day of the month in which the 10th day falls. SER- VICE, CHARGE IS Yh% PER MONTH (18% A-1 ON THE BALANCE OVER 30 DAYS OF AGE. THE BUYER AGREES TO PAY ALL COSTS AND EXPENSES OF COLLECTION. INCLUDING REASONABLE.M71'OR:NEY `s FEES, and EJP claims a mechanic's lien under applicable sane law. Acceptance by E.M All orders from the Buyer are subject to acceptance by autho€'ired personnel of EJP. and, in the case of Open Account Sales, approval of the EJP Credit Department. Cancellations: SPECIAL OR NON -STOCK ITEMS NIAY NOT BE CANCELLED OR RFTURNED AFTER THE PRODUCT(S) IS PLACED INTO PRODUC`T'ION. All charges and costs incurred by EJP as a result of Cancellations or order changes will be, billed to the Buyer. Delivery: EJP will mike a good faith effort to complete delivery' of the products; provided, howev, r, that FJP assumes no responsibility or liability for Toss urdarnage due to delay or inability to deliver, if such non- perfortrance was the result of any events or circurnstances beyo€id the control of EJP. includ- ing, but licit limited to, acts of God, war, labor difficulties, fire, accidents, inability to obtain materials, and dela of earicrS, contractors, suppliers. or manufacuuers. Under no eircumslances shall EJP be liable for any :;peciul, consequential. incidental. indirect., or liquidtited damages, losses, or expense twhcther or not based on negligencvj arising directly or indirectly From delays or Failure to give notici of delay. Shipment: Shipment of all products is io one given destination for all Kerns including pipe, unless otherwise indicates] in writing. Risk of loss shall irans- fer to the Buyer upon lender of goods to Buyer, Buyer's representative, or common carrier. •The cost of any special packing or special handling caused by Buye requirements or requests shalt be added to the amount of the order. If Buyer causes or requests a shipment delay, or if EJP ships or delivers the products erroneously as a result of inaccurate, incornplele or misleading inforruation Supplied by Buyer or its agents or employees, i and all other additional costs and risks shall he bornc Sol ly by Buyer. Claims for products damaged or lost in transit should be made hy,Buyer to the carrier. as EIP s rr spot iblht ceases upon tender of goods to Buyer, Buyer's representative or common carrier. Detivety will be made on hard surfaces only..Any dam- age or towin <a charges resulting from "non hand surface deliveries shall be the responsibility of the Buyer. Inspection and Acceptance: Clai.nrs f:or damage, shortage or errors in shipping must be reported within 1.0 days following delivery to Buyer. Buyer shall have 18 days from the date Buyer receives any ploducrs to inspect such prods €CS and services for defects andrionconformance and tirnlfy EJP; in writing of any def, cts. nonconformance or rejection of such products. After such 10 clay period, Buyer shall be doctried to have irrevocably accepted the prod- ucts. it not previously accepted. After such acceptance, Buyer shall have tto right to reject the products for any reason or to revoke acceptance. Buyer here- by agets that such Ida flay period is a reasonable amcxrnt of time for such inspection and revocation. Returns: Materials cannot be rNlArned without EJP'S written consen t. NO RETURNS ARE ALLOWED AND NO REFUNDS WILL BE MADE ON (i) PIPE OR fit} SPECIALLY FABRICATED OR ORDERED 1TEi1•IS. THE SOLE AND EXCLUSIVE REMEDY FOR SUCH ITEMS ALLEGED TO BE DEFECTIVE IN WORKMANSHIP ORMATERIAL' WILL, BE THE REPLACEMENTOF- THEITEMSSUBJECTTOTHE 49ANUFACTURER'SiNSPEC- fION AND WARRANTY. All other returned material is subject to a MINIMUM 2S4i. IRE: HANDLING CHARGE, plus transportation charges. Unless oiher- wise urreed by the Buyer atnd LIP. all credit for returned material will be applied to future orders, SUbJect to tpPraval by the EJP Credit Department. Warranty: THL; BUYER'S SOLE AND EXCLUSIVE WARRANTY, IF ANY, IS THAT 'PROVIDED BY'I HE PRODUCT "S MANUFACTURER. EJP MAKES N[:) EXPRESS OR IMPLIED WARRANTIES. EJP HEREBY DISCLAIMS ALL EXPRESS OR IMPLIED WARRANTIES, WHETHER IMPl_IF.D BY OPERATION OF LAW OR OTHERWISE, INCLUDING. WITHOUT LIMITATION,, ALL IMPLIED W;ARR:AN'I'IES OF MERCHANTABILITY AND FITNESS OR FITNESS FOR A PARTICULAR. PURPOSE. UNDER NO CIRCUMSTANCES, AND IN NO EVENT, WILL EJP BE LIABLE FOR PERSONAL INJURY OR PROPERTY DAMAGE OR ANY OTHER DOSS, DAMAGE, COST OR REPAIRS OR INC[- DENTAL. PUNITIVE, SPECIAL, CONSEQUENTIAL, OR LIQUIDATED DAIMAGES OF ANY KIND. WHETHER BASED UPON WARRANTY; CONTRACT, STRICT I..:IABILITY, NEGLI,GENCF, OR ANY OTHER CAUSE. OF ACTION .1RISING IN CONNECTION WITH THE DESIGN. MANUF ACFURE. SALE,' I7RANSPOR'1AIION, :INS'] ";YLLAI 'ION. OR REPAIR OF HE PRODUCTS ,SOLD BY EJR BUYER ACKNOWLEDGES AND AGREES THAT TINDER NO CIRCUMSTANCES, AND IN No EVENT. SHALL EJP'S .LIABILITY. IF ANY. EXCEED THE NET SALES PRICE OF THE DEFECTIVE PRODUCT(S). Llitire Agreement: This document constitutes the. entire, complete, and exclusive agreement between the patties with respect to the subject matter here- of and contuitr.e all the agreements and conditions of sale: no course of dealing or us,ige of the trade shall be applicable- "unless expresty incorporated herv- in. The terns and conditions contained herein may nor be added €o, modified, superseded or otherwise altered except by a written modification signed by authorized management personnel f' El All transactions shall be governed solely by the terra.•and conditions contained herein. All purchase orders issued pursuant to an EJP quotation shall be deemed issued subject to all EJP terns and conditions herein contained. These Terris and conditions Shall supersede Ihose of the Buyer- Governing Lacy: This transaction shall be governed in all re peas by the laws of tf €e State of Maine (excluding choice of law provisions). All actions. vegaldicss of form, arising out of or in connection with this transaction, the products sold by EJR or the relationship between life Buyer and EJP shall be brought in the courts of the Static cif Maine within the applicable slaautory period. 1 Comtnunicatiems: Payments only should be directed to: E,.T. Prescott; Inc., 'PO. Box 95o()82, Boston, MA 0`24 1 -0502. All other correspondence and inquidcs shaald be directed air your local EJP Division. The Hone Office address k 32 Prescott Sued, P.Q. Box 600, Gartlinei. Maine 04315. Teteplinue. (207) 582 -1851. Fax (207) 582- 5617. E -mail eiTKQ'ejprescott.com. EJP TsC Rtvi *,ri Date X09 VOUCHER 101500 WARRANT ALLOWED IN SUM OF E.J'. Prescott, Inc. P.CJ_ Box 350002 Boston, MA 02241 -0002 ®4 A `0 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code p!� 4217936 01- 6200 -06 $686.87 LOL4115L) olv6 Voucher Total 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 t 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 88550 E.J. Prescott, Inc. Purchase Order No. P.O. Box 350002 Terms Boston, MA 02241 -0002 Due Date 4/28/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/28/2010 4217936 $686.87 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