190492 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 354275 Page 1 of 1
ONE CIVIC SQUARE T B A OIL WAREHOUSE, INC
I; CHECK AMOUNT: $350.00
CARMEL, INDIANA 46032 2425 E 30TH ST
INDIANAPOLIS IN 46218 -2724 CHECK NUMBER: 190492
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 01JH7073 350.00 TRANSPORTATION EXPENS
TBA Warehouse Invoice
2425 E 30th Street No. Q1JH7073
Indianapolis, IN 46218
317- 923 -2222 FAX: 317-923-2233
Page 1
09:35:49 Sep 07 2010
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
314 O I J H7073 09/07/10. O 1 QQ3339001 NET.l OTH 010.
BILL TO: SHIPPED TO:
CITY OF CARMEL WATER CITY OF CARMEL RATER
1 CIVIC SQUARE 3450 W. 131ST ST
CARMEL, IN 46032 CARMEL, IN 46074
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Dept 002 CITY OF- CARMEL. WATER ContAct: /317- 733 -2853 Rnute:.CARM- EL /WESTFIELD Direction:
YOUR P.O. NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
09/07/10, 09:34-27 .400003 JIM RATLIFF 3 CARMEL /WESTFIELD A 403
ITEM DESCRIPTION UNIT ORDER BACK INV LIST CORE NET NET EXT
BIN QTY ORDERED CITY PRICE 'PRICE PRICE :j CORE PRICE
*Buy out Order, do not
pick. Part is not
returnable after 15 days
from purchase
BUY OUT 5W30SYN 55GAL OIL NONE EA 1 .0 1 499.00 0.00 350.00 0.00 350.00,
TOTAL PURCHASE FREIGHT TAX PCT TAX AMT NVOICE TOTAL PAYMENTS BALANCE DUE
350.00 0.00 0.00 350.00 0.00 350.00
1,5 service charge on past due accounts(18 %..per annum).
Core returns must be in original box. All new returns must
be resaleable. return after 30 days. without invoice.
VOUCHER 102811 WARRANT ALLOWED
354275 IN SUM OF
TBA WAREHOUSE- -INDY 4NT
2425 E 30TH STREET
INDIANAPOLIS, IN 46218 co
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
01JH7073 01- 6500 -04 $175.00
01JH7073 01- 6500 -05 $175.00
Voucher Total $350.00
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
354275
TBA WAREHOUSE -INDY Purchase Order No.
2425 E 30TH STREET Terms
INDIANAPOLIS, IN 46218 Due Date 9/20/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/20/2010 01 J H7073 $350.00
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 O r