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162885 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 354175 Page 1 of 1 ONE CIVIC SQUARE MYRON CORP CHECK AMOUNT: $140.21 CARMEL, INDIANA 46032 PO Box 602616 CHICAGO IL 60680 -2616 CHECK NUMBER: 162885 CHECK DATE: 8/20/2008 DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION 2201 4230200 66758582 140.21 OFFICE SUPPLIES i M E O �PO BOX 802616 Please Update CHICAGO, IL 60680 -2616 I Your Records! TEL 800 526 -9766 F AX 800 646 -1443 Mail All Checks to: Questions? PO Box 802616 Email us at invoiceHELP @myron.com Chicago, IL. 60680 -2616 BILL TO: SHIP TO: MR. Dave Hoffman MR. Dave Hoffman City Of Carmel Street Dept City Of Carmel Street Dept 3400 W 131st St 3400 W 131st St Westfield, IN 46074 -8267 Westfield, IN 46074 -8267 0114912680667585820000 140211066758582 PAYME ?'T DUE ACCOUNT INVOICE /ORDER DATE SHIPPED YOJR P4 9/03/08 11491268 66758582 8/04/08 UNIT QUANTITY ITEM DESCRIPTION PRICE AMOUNT 53 WC91C45B BERGAMO II GUNMETAL /GOLD- RUBBERIZED 1.990 105.47 1 NOBOXES NO GIFT BOXES OR ENVELOPES SELECTED .000 .00 1 04SETLSR LASER BASIC SET UP CHARGE 15.950 15.95 Please inspect your product when it arrives! We realize you may not use the product until later in the year, and want to ensure you received your order to your specifications. PACKAGE TRACKING NUMBER INFORMATION SHIPPING /HANDLING 18.79 1ZF04W980301700065 PAYMENT .00 AMOUNT DUE 140.21 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)) 08/04/08 66758582 $140.21 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 20 Clerk- Treasurer VOUCHER NO: WARRANT NO. ALLOWED 20 Myron Corp IN SUM OF P. O. Box 802616 Chicago, IL 60680 -2616 $140.21 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 2201 66758582 42- 302.00 $140.21 1 hereby certify that the attached invoice(s), or 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 Thursday, August 14, 2008 Street Co issioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund