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191220 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 358710 Page 1 of 1 s 0 ONE CIVIC SQUARE H D SUPPLY WATERWORKS LTD CHECK AMOUNT: $131.34 �a CARMEL, INDIANA 46032 P 0 BOX 91036 CHICAGO IL 60693 CHECK NUMBER: 191220 CHECK DATE: 10/27/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 1980208 131.34 OTHER EXPENSES Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You. We appreciate your prompt payment. Date Ordered Date Shipped Customer PO No. Job Name Job No. Bill of Lading Shipped Via Order Number 9/21/10 9/23110 VERBAL MIKA MARKING FLAGS UPS 1980208 Product Code Description Quantity Quantity Back- Price Per Amount Ordered Shipped Ordered HD SUPPLY WATERWORKS PO 4847190 96FLAGGSF 4X5 GREEN FLAG MARKED SEWER 1000 1000 .12000 EA 120.00 "SEWER" MUST BE IN WHITE LETTERING ON 18" WIRE STAFF to o re This transaction is governed by and subject to HD Supply Waterworks standard terms Terms SubTotal and conditions, which are incorporated herein by this reference and accepted. To review these terms and conditions, please point your web browser to http:I/ waterworks.hdsupply.com/TandC NET 30 120.00 Freight Delivery Handlinq Restock Misc. Tax 11.34 NNW $131.34 HDSWW INDIANAPOLIS IN -W THANK YOU FOR YOUR ORDER Branch 430 VISIT —fill s 1980208 1680 Expo Lane WATERWORKS. HDSUPPLY.COM Indianapolis IN 46214 FOR OTHER SERVICES OFFERED 0001:0001 Page 1 of 1 VOUCHER 106435 WARRANT ALLOWED 86201 IN SUM OF HD SUPPLY WATERWORKS LTD (NA P.O. Box 91036 CHICAGO, IL 60693 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 1980208 01- 7200 -02 $131.34 Voucher Total $131.34 Cost distribution ledger classification if claim paid under vehicle highway fund Prescribed by State Board of Accounts City Form No 201 (Rev 19959 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 4. 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 86201 HD SUPPLY WATERWORKS LTD (NATIONAL 1 Purchase Order No. P.O. Box 91036 Terms CHICAGO, IL 60693 Due Date 10/19/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/19/2011 1980208 $131.34 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 Date Officer