187239 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00352276 Page 1 of 1
ONE CIVIC SQUARE BREAKERS UNLIMITED
CARMEL, INDIANA 46032 15241 STONY CREEK WAY CHECK AMOUNT: $172.50
NOBLESVILLE IN 46060
CHECK NUMBER: 187239
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1029901 -01 172.50 OTHER EXPENSES
15241 Stony Creek Way
Noblesville,
INVOICE 7 1 7 .8817
..t Office 317 776.8817
Toll free 800 1875.3294
Fax 317 1 773.9867
One call. In s R now. breakers unlimited. co
COLORADO GEORGIA INDIANA NEVADA TEXAS
CUSTOM CODE -j SHIP 1 TR If INVOI N UMBER
CAR700 1029901 -01
J 317 571 2634
0
DTO CARMEL WASTEWATER UTILITIES STO HIP CARMEL WWTP
0) 0 760 THIRD AVE SW SUITE 110 9609 HAZEL DELL PRKWY
CARMEL IN 46032 INDIANAPOLIS IN 46280 0
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a` N CUSTOMER P.O. NO. S12193
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SHIP 1 TR 1 I NVOICE NUMBER SLSMN, ORDER DATE FAKER CUSTOMER P.O. NUMBER DATE S9
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V Y 1029901 -01 100 06/15/10 180 S12193 06/15/10 CD o
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2 2 QOB330 EA 86.25 172.50 O O
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THIS IS YOUR INVOICE SUBTOTAL 172.50
MISC. CHARGE
FREIG IN FREIGHT OUT TELE. CHARGE
FREIGHT TOTAL
FEDJOTHER TAX
NET TERMS: INV 30 DUE: 07/15/10 STATE TAX
ORDER COMPLETED PAYMENT RECD. 0.00
Please Remit Payment To: Breakers Unlimited TOTAL AMT DUE
15241 Stony Creek Way 172.50
Noblesville, IN 46060
I
VbUCHER 105709, _WARRANT ALLOWED
z
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
1029901 -01 01- 7202 -06 $172.50
Voucher Total $172.50
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 19 5)
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 6/22/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/22/2010 1029901 -01 $172.50
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
7�// o t���-v' 1 i'`'ce• ;b�
Date Officer