189665 09/14/2010 "4 CITY OF CARMEL, INDIANA VENDOR: 358688 Page 1 of 1
ONE CIVIC SQUARE AGRO CHEM
1, CARMEL, INDIANA 46032 2045 S WABASH STREET CHECK AMOUNT: $24.73
WABASH IN 46992
CHECK NUMBER: 189665
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4238000 IN00470061 24.73 SMALL TOOLS MINOR E
Date Invoice
AGRO CHEM, INC. I
AGRO CHEM 2045 S WABASH STREET 8/26/2010 IN00470061
WABASH, IN 46992
Phone: 800 -686 -5680
Fax: 888 -281 -4321
www.agrochem.com
Bill To Ship To
CITY OF CARMEL INDIANA CITY OF CARMEL INDIANA
3400 WEST 131 STREET 3400 WEST 131 STREET
WESTFIELD,IN 46074 WESTFIELD,IN 46074
S-�I k I ;:MA:EPNTTS T °Bl -MOiv T HL PLEASE'PA V'f+ tCOM INVOICE
P.O. Number Rep Ship Via Terms Due Date
5 8/26/2010 UPS NET 30 DAYS 9/25/2010
Ordered Shipped B10 Item Code Description Price Each Amount
1 1 0 200C FEMALE COUPLER THOSE BARB 17.49 17.49
1 1 0 SHIPPING 7.24 7.24
k4o
400
Total $24.73
i
VOUCHER NO. WARRANT NO.
I ALLOWED 20
Agro Chem, Inc.
IN SUM OF
2045 S. Wabash Street
Wabash, IN 46992
I
$24.73
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1192 IN00470061 42- 380.00 $24.73
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
j which charge is made were ordered and
received except
Monday September 13, 2010
Director, D GS
y
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/26/10 IN00470061 coupler for water tank $24.73
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
20
Clerk- Treasurer