196134 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 316200 Page 1 of 1
ONE CIVIC SQUARE UTILITY SUPPLY CO INC.
CARMEL, INDIANA 46032 6310 S HARDING ST CHECK AMOUNT: $121.95
INDIANAPOLIS IN 46217
CHECK NUMBER: 196134
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D E S CRIPTION
651 5023990 1024350 121.95 MATERIALS SUPPLIES
i
INVOICE
UTILITY SUPPLY COMPANY
Branch: 03 USC NW INDY INVOICE
S. 6310 SOUTH HARDING STREET 1024350
INDIANAPOLIS, IN 46217 Invoice Date Page
f.0
U S 1 1/19/2010 15:12:51 1 01' 1
ORDER NUMBER
317- 783 -4196 1025941
Bill To: Ship To:
CARMEL WASTEWATER DEPARTMENT CARMEL WASTEWATER DEPARTMENT
9609 HAZEL DELL PARKWAY 9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
US US
Attn: JEFF COOPER Ordered 13y:.lE1-F COOPER
Castonier_ID:_ 1.00766
PO Number Terns Description Net Due Date Disc Due Date Discount Amount
JEFF Net 30 DAYS 12/19/2010 12/19/2010 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
11/19/2010 10:10:32 1026699 DOUG KARST ZSTIERWALT
Quantities Pricing
Item ID U0A1 Unit Pxtended
Ordered Shipped Remaining UOM O (tern Description price Price
Unit Size U�rit .S l yL'
Carrier: CUSTOMER PICK UP Tracking
4.00 4.00 0.00 FT 36CULVERT 1'T 30.4867 121.95
1.0 36 DUAL WALL POLY BELL END 1.0000
Total Limes: I SUB- TOTAL: 121.95
TAX: 0.00
A FINANCE CHARGE Computed at a periodic rate of 1 1/2 per month (I AMOUNT DUE.• 121.95
ANNUAL PERCENTAGE RATE) is applied to PAST DUE ACCOUNTS OVER 30 DAYS.
*REPRINT
VOUCHER 107403 WARRANT ALLOWED
316200 IN SUM OF
UTILITY SUPPLY CO INC.
.6310 S HARDING ST
INDIANAPOLIS, IN 46217
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1024350 01- 7202 -06 $121.95
Voucher Total $121.95
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
316200
UTILITY SUPPLY CO INC. Purchase Order No.
6310 S HARDING ST Terms
INDIANAPOLIS, IN 46217 Due Date 3/25/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/25/2011 1024350 $121.95
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
S 91/
Date Officer