166137 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 00352276 Page 1 of 1
ONE CIVIC SQUARE BREAKERS UNLIMITED
CARMEL, INDIANA 46032 15241 STONY CREEK WAY CHECK AMOUNT: $172.50
NOBLESVILLE IN 46060 CHECK NUMBER: 166137
CHECK DATE: 11/2412008
DE PARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 147441201 172.50 OTHER EXPENSES
BREAKERS UNLIMITED BREAKERS UNLIMITED, CO BREAKERS UNLIMITED, GA BREAKERS UNLIMITED, CA BREAKERS UNLIMITED, TX
r 15241 Stony Creek Way 5905 Lamar Street 100 Petty Road, Suite F 5880 District Boulevard, Suite 2 12821 Duncan Road, Suite A
j� Noblesville, IN 48060 Arvada, CO 80003 Lawrenceville, GA 30043 Bakersfield, CA 93313 Houston, TX 77066
Toll Free:(800) 875.3294 Toll Free,(800) 227.5731 Toll Free:(888) 237.8923 Toll Free: {877) 232.8732 Toll Free:(800) 875.3294
r r •rr r• r: r r
CUSTOMER C ODE SHIP 1 TR INVOICE NUMB
CIT666 1474412 -01
317 -571 -2443
BILL CITY OF CARMEL SHI CAZRMEL WWTP
750 THIRD AVE SW 9609 HAZEL DELL PARKWAY
CARMEL IN 46032 INDPLS IN 46280
CUSTOMER P.O. NO. S11430
SHIP I TR! INVOICE NUMBER SLSMN. ORDER DATE TAKER CUSTOMER P.O. NUMBER DATE
1474412 -01 100 11/06/08 180 S11430 11/06/08
INSTRUCTIONS FRT. PAGE NO,
WILL CALL T 1
QUANTITY
ORDERED B.C. RET. SHIPPED DISP. ITEM CODE AND DESCRIPTION Ulm UNIT PRICE AMOUNT
1 1 QOU3100 EA 172.50 172.50
3P- 10OA- 240VAC
THIS IS YOUR INVOICE SUBTOTAL 172.50
MISC. CHARGE
FREIGHT IN FREIGHT OUT TELE. CHARGE
FREIGHT TOTAL
FEDJOTHER TAX
NET TERMS: INV 30 DUE: 12/06/08 RTATF TAX
ORDER COMPLETED PAYMENT RECD. 0
Please Remit Payment TO: Breakers Unlimited TOTAL AMT DUE
15241 Stony Creek Way 172.50
Noblesville, IN 46060
VOUCHER 086682 WARRANT ALLOWED
352276
IN SUM OF
BREAKERS UNLIMITED
15241 Stony Creek. Way
Noblesville, IN 46060
L.,
Carmel Wastewater Utility
8s
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
147441201 01- 7200 -03 $172.50
-!e
w
e'
Voucher Total $172.50
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
352276
BREAKERS UNLIMITED Purchase Order No.
15241 Stony Creek Way Terms
Noblesville, IN 46060 Due gate 11/18/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/18/2001 147441201 $172.50
'S
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer