167354 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 359478 Page 1 of 1
ONE CIVIC SQUARE HILLYARD INDIANA CHECK AMOUNT: $394.55
s ?4 CARMEL, INDIANA 46032 P 0 BOX 872361
KANSAS CITY MO 64187 -2361 CHECK NUMBER: 167354
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 511446 2705521 TT 394.55 PAPER.TOWELS, TRASH B
ar,
m
HIL IYARD Please Note New Remit Address CUSTOMER COPY
Remit To:
�l j� HILL YARD/ INDIANA
THE CLEANING RESOURCE A �R P.O Box: 872361
Plant: 1350 0 Kansas City MO 64187 -2361 Invoic
Phone: 765 378 3766
Fax: 765 378 6671
www.hi4yard.com
CARMEL W.W.T. P. -WASTEWATER TEWATER UTILIT
To 9609 HAZEL DELL PARKWAY
of
Ship p
INDIANAPOLIS IN 46280 Customer Number: 272994
Invoice Number 2705521
Invoice Date 12/05/2008
Bill CARMEL UTILITIES Purchase Order No. S11446
To WASTEWATER
760 THIRD AVENUE SW SUITE 110 Packing List Number 82688310
CARMEL IN 46032 Sales Order Number 11066907
Payment Terms Net due in 30 days
Page 1 of 1
Invo t3eat[s
ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT
polo PAP10150 6 CS 26.73 160.38
TOWEL KITCHEN ROLL GSC 2 PLY 90 PKG 30CS
0020 LR4348170K 2 CS 40.93 81.86
LINER 56GAL 43X48 1 .7MIL BLK 100 /CS PAYL
0030 PAP10110 3 CS 45.77 137.31
TOWEL ROLL NAT WHT CONTROL GSC 80OFT 6CS
Subtotal 379.55
Shipping 15.00
Tax Amount 0.00
Gross Price 394.55
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 THIS INVOICE.
PLEASE DETACH AT THE PERFORATION ABOVE AND RETURN THIS STUB WITH YOUR PAYMENT. IT WILL INSURE PROPER CREDITING TO YOUR ACCOUNT.
HILLYARD Plant: 1350
HILL YARD INDIANA Customer No. 272994
THE CLEA RESOURCE' P. O. Box: 872361 Invoice No. 2705521
Kansas City MO 64187 -2361 394.55
REMITTANCE STUB
THANK YOU!
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
359478
HILLYARD /INDIANA Purchase Order No.
PO BOX 872361 Terms
KANSAS CITY, MO 64187 -2361 Due Date 12/15/2008
Invoice Invoice Description
Date Number, (or note attached invoice(s) or bill(s)) Amount
12/15/2001 2705521 $394.55
,u
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
VOUCHER 086924 WARRANT ALLOWED
359478 IN SUM OF
HILLYARD /INDIANA
PO BOX 872361
KANSAS CITY, MO 64187 -2361
Carmel Wastewater Utility
CAN ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
2705521 01- 7201 -05 $379.55
2705521 01- 7201 -05 $15.00
1
�h
Voucher Total $394.55
Cost distribution ledger classification if
claim paid under vehicle highway fund