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193443 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 359478 Page 1 of 1 ONE CIVIC SQUARE HILLYARD INDIANA CHECK AMOUNT: $459.50 CARMEL, INDIANA 46032 P 0 BOX 872361 KANSAS CITY MO 64187 -2361 CHECK NUMBER: 193443 CHECK DATE: 1/512011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4236500 6579222 459.50 SALT CALCIUM PLEASE DETACH AT THE PERFORATION ABOVE AND RETURN THE STUB WITH YOUR PAYMENT. IT WILL INSURE PROPER CREDITING TO YOUR ACCOUNT. ela p q ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT oolo HIL29934 50 EA 8.89 444.50 HILLYARD SPEC BLEND ICE MELT 50 LB BAG Subtotal 444.50 Shipping 15.00 Tax Amount 0.00 I Gross Price 459.50 fl Q a JAN 0 4 2011 By Invoice Number 6579222 Date 12/22/2010 Purchase Order: Mayor's Office V Plant: 1350 Customer Number 256298 CITY OF CARMEL H ILLYARD HILLYARD /INDIANA Invoice A O. Box. 872367 Tfffi CLVMG RBOURCE* Kansas City, MO 64187-2361 CUSTOMER COPY THANK YOU! THE SELLER REPRESENTS IT HAS FULLY COMPLIED WITH THE PROVISIONS OF THE FAIR LABOR STANDARDS ACT OF 1938, AS AMENDED, IN THE MANUFACTURE OF GOODS COVERED BY TKS INVOICE. VOUCHER NO. WARRANT NO. ALLOWED 20 Hillyard Indiana AZ IN SUM OF PO Box 872361 Kansas City, MO 64187 -2361 $459.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Administration PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1205 6579222 1 42- 365.00 I $459.50 1 hereby certify that the attached invoice(s), or I i 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 Tuesday, January 04, 2011 J Director, Administration 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)) 12/22/10 6579222 $459.50 1 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