163210 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 00351836 Page 1 of 1
0 ONE CIVIC SQUARE GASOLINE EQUIPMENT CHECK AMOUNT: $564.95
CARMEL, INDIANA 46032 PO BOX 10474
oM ,�o FORT WAYNE IN 46852 CHECK NUMBER: 163210
CHECK DATE: 9/3/2008
DEPARTMENT ACC PO NUMBER INVOICE NUMBER AMOU DESCRIPTION
651 5023990 S11371 12972101 564.95 HOSES NOZZLES
INVOICE
INVOICE
NUMBER 129721 -01
0 0 I INVOICE
4422 EARTH DRIVE -FORT WAYNE, INDIANA 46809 (260) 747 -5088
DATE 8/21/2008
REMIT TO: P.O. BOX 10474 FORT WAYNE, IN 46852
F
S Carmel Utilities S Carmel Waste Water
O Water Wastewater H Treatment Plant
L 760 3rd Ave. SW, Ste 110 1 9609 Hazel Dell Parkway
D Carmel, IN 46032 P Indianapolis, IN 46280
T T
O O
S ER COUNT
511371 081-92008-- MA R -K NET -10 DAYS 316—
NO PCD PART NUMBER LC DESCRIPTION ORDERED SHIPPED
P DISC UNIT COST U M COS
1 IRP 123381 2 1 "X14' STEEL FLEX 2 2
70.82 .0000 70.82 EA 141.64
2 HYN 265704 2 1 +10 N -L NOZZLE 1 1
63.44 .0000 63.44 EA 63.44
3 HYN 052410 2 1HS DIESEL NOZZLE 1 1
71.72 .0000 71.72 EA 71.72
4 TUA 901 2 METER 1 1
288.15 .0000 288.15 EA 288.15
MATERIAL TOTAL 564.95
AMOUNT DUE 564.95
TAX EXEMPT NO:003 120 1550010/020 PAGE 1
MINIMUM BILLING $10.00
A FINAN(:F (:I- IAR(.F ()F 1 1/9 PFR M()NTI4 11A ANN[1AI RATFI IA/II I RP AnnFn T(l Al I PACT nl IF A(:(:(1I INTC i
VOUCHER 086190 WARRANT ALLOWED
00351836 IN SUM OF
GASOLINE EQUIPMENT
P.O. Box 10474
Ft. Wayne, IN 46852
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
12972101 01- 7202 -06 $564.95
Voucher Total $564.95
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.
P�
Payee
00351836
GASOLINE EQUIPMENT Purchase Order No.
P.O. Box 10474 Terms
Ft. Wayne, IN 46852 Due Date 8/26/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/26/2008 12972101 $564.95
hereby certi fy 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