191594 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 358492 Page 1 of 1
Q� ONE CIVIC SQUARE COMMERCIAL MAINTENANCE CHEMIC CHECK AMOUNT: $665.98
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CARMEL, INDIANA 46032 4190 SUNRISE HWY
MASSAPEQUA NY 11758 CHECK NUMBER: 191594
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 E13678 665.98 OTHER EXPENSES
Invoice
43 Commercial Maintenance Chemical Invoice Number:
43 HEISSER COURT
FARMINGDALE, NY 11735 E13678'
Invoice Date:
Phone: 516 804 -8603 Nov 1, 2010
Pax: 516 -804 -8659 Page:
1
Sold To: Shi to:
CARMEL CITY SEWER WATER CARMEL CITY WATER SEWER
760 3RD AVE. SW 901 N. RANGELINE
CARMEL IN 46032 CARMEL, IN 46032
us 1D
Customer FG
Pa yment T
E-5-9-2 _erm s
61 P. ARNONE I
ate Net 30 Days
Sales Rep ID Shipping Method Ship D D ue Date
JOHN WRIGHT UPS Ground 10122110 12/1/10
Quantity Item Description Unit Pric Ext ension
120.00FRD GRANULAR ROOT DESTROYER 4.89
586.80
ALL SALES ARE FINAL. Subtotal 586.80
Sales Tax
Freight 7 9.18
Total Invoice Amount 665.98
Check/Credit Memo No: Payment /Credit Applied
TOTAL 665.9®
\''OUCHER 106528 WARRANT ALLOWED
358492 IN SUM OF
COMMERCIAL MAINTENANCE CHEMI(
4190 SUNRISE HWY
MASSAPEQUA, NY 11758
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
E13678 01- 7200 -02 $665.98
I
Voucher Total $665.98
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
358492
COMMERCIAL MAINTENANCE CHEMICAL Purchase Order No.
4190 SUNRISE HWY Terms
MASSAPEQUA, NY 11758 Due Date 11/4/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/4/2010 E13678 $665.98
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
l S/� a C4 {n'
Date Officer