159568 05/14/2008 F CITY OF CARMEL, INDIANA VENDOR: 361182 Page 1 of 1
0 ONE CIVIC SQUARE RIVERA FINANCE CHECK AMOUNT: $169.78
CARMEL, INDIANA 46032 PO BOX 905714
CHARLOTTE NC 28290 CHECK NUMBER: 159568
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 16467 169.78 OTHER EXPENSES
Freedom Contractor's Supply
P.O. Drawer 960
Madison, Florida 32341
Date 4/8/2008
Invoice 16467
BIIlTa S;htpTn .u.
Carmel Water Carmel Water
3450 W. 131 st. Street 3450 W. 131 st. Street
Westfield, IN 46074 Westfield, IN 46074
Cust.ID 317 733 -2855 Ship Date 4/8/2008
Terms Net 30 Due Date 5/8/2008
Cust. PO Jack
pw,s Z x
Items Descr�lptan Q`ty �Pr� ce Amounts
Tools Insertion Tools 3 49.99 149.97
Shipping Shipping Charges 19.81 19.81
NOTICE OF ASSIGNMENT
THIS INVOICE HAS BEEN SOLD
ALL INVOICES HAVE BEEN
ASSIGNED MUST BE PAID
DIRECTLY TO
RIVIERA FINANCE
P.O. Box 905714
Charlotte, NC 28290 -5714
ANY CLAIMS, OFFSETS,
DISPUTES OR QUESTIONS
CONCERNING ANY INVOICE
MUST BE REPORTED TO
RIVIERA FINANCE IMMEDIATELY
AT (800) 334 -2092
Have a great day!
Subtotal $169.78
Sales Tax (7.0 $0.00
Total $169.78
Freedom Contractor's Supply
1- 800 -263 -0635
www.freedomsupplycompany.com Fax 1- 850 -973 -2619 Balance Due $169.78
VOUCHER 081714 WARRANT ALLOWED
;n 182 IN SUM OF
RIVIERA FINANCE ��i
RO BOX 905714
CHARLOTTE, NC 28290- 5714Q.
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
16467 01- 6200 -06 $169.78
J
1
�T
Voucher Total $169.78
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 j
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
P
361182
RIVIERA FINANCE Purchase Order No.
PO BOX 905714 Terms
CHARLOTTE, NC 28290 -5714 Due Date 5/7/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/7/2008 16467 $169.78
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
Date er