189745 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 364575 Page 1 of 1
0 ONE CIVIC SQUARE CUMMINS ALLISON CORP
CARMEL, INDIANA 46032 5696 W 74TH STREET CHECK AMOUNT: $1,575.77
INDIANAPOLIS IN 46278
CHECK NUMBER: 189745
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4464000 21713 3646002 1,575.77 CASH COUNTER
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CUMMINS Page 1 of 1
CUMMINS- ALLISON CORP. INVOICE
Invoice Number 3646002
P.O. BOX 339 Invoice Date OB -23 -10
MT.PROSPECT, IL 60056 Customer Number 41954
Telephone 847- 299 -9550 Customer P.O. Number 21713
Fax 847- 299 -4939 Cummins Order Number F58136
Cummins local office CUMMINS- ALLISON INDY #68 317 -872 -6244 Order Type Factory Order
Federal ID 35- 0145140
Reference Number MW68010012
Bill to: Ship to:
ATTN: D CORDRAY ATTN: CLERK TREASURER
IN CITY OF CARMEL IN CITY OF CARMEL
ONE CIVIC SQUARE ONE CIVIC SQUARE
CARMEL,IN 46032 CARMEL,IN 46032
UNITED STATES
Terms NET 10
Ship date 08 -20 -10 Ship condition PREPAY AND ADD Ship via UPS GROUND COMMERCIAL
Part Number Description Qty Ordered Qty Shipped Amount
406 9903 -00 JETSCAN 4063 1 1 1,295.00
Serial Numbers
14063105009037
SUBTOTAL 1,295.00
Freight 10.77
SALES TAX 0.00
406- 9003 -SCIOl Maintenance Contract Nbr: 63816710 Service
Equipment 406 9903 -00 L--1 JETSCAN 4063
Serial Number 14063105009037
Location ONE CIVIC SQUARE CARMEL IN,46032
Contact 317 571 -2414 DIANA CORDRAY
Service Fac 68 CUMMINS ALLISON TNDY 468
Contract Period 11 -25 -10 TO 11 -24 -11 270.00
Service Starts 11 -25 -10 Parts 32.40 0.00
SALES TAX 0.00
INVOICE TOTAL 1,575.77
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
tl Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
bo A 339
b�
ON ACCOUNT OF APPROPRIATION FOR
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1
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT_ I hereby certify that the attached invoice(s), or
y�i Z (�1J, 7� bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
P *ar
Signatur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund