187864 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 358928 Page 1 of 1
0 ONE CIVIC SQUARE HORNER INDUSTRIAL SERVICES, INC CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 PO BOX 660292
INDIANAPOLIS IN 46266 -0292 CHECK NUMBER: 187864
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 762651 150.00 CONT SERVICES OTHER
HORN -R Invoice: 762651
Date: 6 -28 -2010
IN DUSTRIAL S 61WICHS, FNIC.
Serving the Electrical/Electronics Industry since 1949 REMIT -TO ADDRESS
1521 East Washington Street, Indianapolis, IN 46201 Horner Industrial Services, Inc.
Phone 317 639 -4261 Fax 317 639 -4279
P. O. Box 660292
Indianapolis,IN 46266 -0292
Bill To: Ship To:
CITY OF CARMEL UTILITIES CITY OF CARMEL UTILITIES
ATTN ACCOUNTS PAYABLE ATTN ACCOUNTS PAYABLE
3450 W 131ST STREET 3450 W 131 ST STREET
WESTFIELD IN 46074 WESTFIELD IN 46074
F.O.B SHIPPING POINT
Fax: 317 733 -10253
Cust Acct: APO Numbe n Salds OOrder Fr
eig Ship
Terms �Shi p Date a.`.� Via
Terms..
1294 P5- 062510 -BT 12778 ALLOWED 6/25/2010 WILL CALL Net 30 Days
Quantity
Ln Shipped B/O Part IVo Description
pp p n /Customer Part Number' 'Unit Price T/R Amount
I
UNIT RETURNED NO REPAIR PER CUSTOMER REQUEST. IN PEC TION FEE ONLY.
Invoice Instructions and Notes:
Credit Terms: A service charge of 2% per month, (24% per Annum) will be added to all Sub Total l $150.00. i 1,
past -due invoices. iw
Tax,'
Return Goods: a 20% restocking charge applies to all normal stock items. Goods may not be returned
without prior authorization. 4 0 00
Less Deposits
Warranty: Please track all serial numbers for warranty purposes.
VENDEE agrees to pay all applicable sales and use taxes to proper authorities. Invoice Total $150.00 Please Pay This Amount
Customer has FIVE(5) working days to notify Horner Industrial Services of all shipping discrepancies.
Page: 1 of 1
VOUCHER 1021 ,30 WARRANT .ALLOWED
134000 IN SUM OF
HORNER INDUSTRIAL SERVICES
PO BOX 660292
INDIANAPOLIS, IN 46266 -0292
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
762651 01- 6360 -04 $150.00
Voucher Total $150.00
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
134000
HORNER INDUSTRIAL SERVICES Purchase Order No.
PO BOX 660292 Terms
INDIANAPOLIS, IN 46266 -0292 Due Date 7/12/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/12/2010 762651 $150.00
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 fi /v W,
Date Officer