167337 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 319510 Page 1 of 1
j_ ONE CIVIC SQUARE GRAINGER INC CHECK AMOUNT: $218.05
CARMEL, INDIANA 46032 DEPT 804572097
PALATINE IL 60038 -0001 CHECK NUMBER: 167337
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMB INVOICE N UMBER AMO DESCRIPTION
651 5023990 9795199596 62.38 OTHER EXPENSES
1115 4237000 9795997031 140.12 REPAIR PARTS
1150 4237000 9796800812 15.55 REPAIR PARTS
PAGE 1 OF 1 A
IA71T*- calm
GRADIGER GRAINGER ACCOUNT NUMBER 804491322
Min INVOICE NUMBER 9795997031
9210 CORPORATION DR. INVOICE DATE 12/09/2008
INDIANAPOLIS, IN 46256 -1017 DUE DATE 01/08/2009
AMOUNT DUE 140.12
SHIP TO
PO NUMBER: BRIAN SMITH
CITY OF CARMEL CALLER: BRIAN SMITH
760 3RD AVE SW STE 110 CUSTOMER PHONE: (317) 571 -2443
CARMEL, IN 46032 -0000 DELIVERY NUMBER: 6090391355
INCO TERMS: FOB ORIGIN
BILL TO
MDG2005 00038979 1 MB 0369
CARMEL WATER UTILITIES
3450 W 131ST ST
WESTFIELD, IN 46074 -8267 038979 THANK YOU!
FEI NUMBER 36- 1150280
FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 317 842 -2497
7 #FLE15/21 IA19XL
68950 PLEATED FI 12 6.02 72.24
MANUFACT COMPACT FPS,FLE15 /2 /A19XL 4 16.97 67.88
MANUFACTURER
NUMBER OF PKGS. 0 WEIGHT: 1240 INVOICE SUB TOTAL 140.12
DATE SHIPPED. 12/09/2008
These items are sold for domestic consumption in the United Slates. If exported, purchaser assumes full
responsibility for compliance with US export c
PAYMENT TERMS NET 30 DAYS. PAY THIS INVOICE NO STATEMENT SENT. PAYABLE IN U.S. DOLLARS. AMOUNT DUE 940.12
SALES, FREIGHT AND WARRANTY TERMS AND CONDITIONS
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2S"3 100-
VOUCHER NO. WARRANT NO.
ALLOWED 20
Grainger
IN SUM OF
Dept. A28999-7-55- S )'4 y
Palatine, IL 60038
$140.12
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 9795997031 42- 370.00 $140.12 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
Wednesday, December 17, 2008
Director
Title
Cost distribution ledger classification if
claim paid motor 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 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))
12/09/08 I 9795997031 I I $140.12
1 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
GRAZNGER
U PAGE 1 OF 1
GRAINGER ACCOUNT NUMBER 813555497
INVOICE NUMBER 9795199596
9210 CORPORATION DR. INVOICE DATE 12/08/2008
INDIANAPOLIS, IN 46256 -1017 DUE DATE 01/07/2009
AMOUNT DUE 62.38
SHIP TO
PO NUMBER: JOHN 278
CARMEL WASTEWATER CALLER: JOE FAUCE17
9609 HAZEL DELL PKWY CUSTOMER PHONE: (317) 571 -2634
INDIANAPOLIS, IN 46280 -2935 DELIVERY NUMBER: 6090315446
INCO TERMS: FOB ORIGIN
BILL TO
MDG2005 00036992 1 MB 0369
CARMEL WASTEWATER UTILITY
760 3RD AVE SW STE110
CARMEL, IN 46032 -2584 036992 THANK YOU!
FEI NUMBER 36- 1150280
FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 317- 842 -2497
7 74A803 TILITY KNIFE,3 BLADES 4 4.61 18.44
MANUFACTURER 10 -099
CRAPER,RAZOR BLADE 4 2.55 10.20
MANUFACTURER 28 -500
4A807 RAZOR BLADE,PK100 1 5.23 5.23
MANUFACTURER 11 -515
5R711 UTILITY BLADE,PK100 1 19.32 19.32
MANUFACTURER 11 -988
5YK56 REMOVER,GASKET,16 OZ,NET 12 OZ 1 9.19 9.19
MANUFACTURER 03017
NUMBER OF PKGS: 0 WEIGHT: 4.50 INVOICE SUB TOTAL 62.38
DATE SHIPPED: 12108008
These items are sold for domestic consumption in the United States. If exported, purchaser assumes full
responsibility for compliance with US exp co ntrols
PAYMENT TERMS NET 30 DAYS. PAY THIS INVOICE NO STATEMENT SENT. PAYABLE IN U S DOLLARS AMOUNT DUE 62.38
.-4 "—Ift
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liS- S
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0
California Fropasition 65. 1 lt�atir Calk-: 'i�z: f1mi :,t� i� o s r I ;la n:rq iol_xts z;ti aek
p- )u" ness -I z ill trjl:s�,T ta n'l. tN,'t to i,k'l!n nr ni'so.3; tilt I a ll, 11 1
i Foi p(lI,(,lQ I:lm ;1 0 (a r0•, lw; >Ie il llla kjw ed hv rsti!t,
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a 'I
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?S -i53 1017 i
VOUCHER 086938 WARRANT ALLOWED
551533 IN SUM OF
GRAINGER INC
DEPT. 804572097
PALATINE, IL 60038 -0001
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
9795199596 01- 7202 -06 $62.38
ti.
Voucher Total $62.38
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) v
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
351533
GRAINGER INC Purchase Order No:
DEPT. 804572097 Terms
PALATINE, IL 60038 -0001 Due Date 12/16/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/16/2= 9795199596 $62.38
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
1
s PAGE 1 OF 1 0 M3=
GRAINGER ACCOUNT NUMBER 804491322
L /ills INVOICE NUMBER. 9796800812
5959 W. HOWARD STREET INVOICE DATE 12/09/2008
NILES, IL 60714 -4014 DUE DATE 01/08/2009
AMOUNT DUE 15.55
SHIP TO
PO NUMBER: BROOKSHIRE
CITY OF CARMEL CALLER: KEN MILLER
12120 BROOKSHIRE PKWY CUSTOMER PHONE: (317) 571 -2443
CARMEL, IN 46033 -3314 DELIVERY NUMBER: 6090382993
INCO TERMS: FOB ORIGIN
BILL TO
MDG2005 00038979 1 MB 0369
CAR LWAT TILITIES
3450 T ST
WESTF D, N 46074 -8267 THANK YOU!
FEI NUMBER 36- 1150280
FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 1- 877 202 -2594
a o ,k,
2WY60 REDUCING SPUD, URINAL AND TOILET, 1X3/4 IN 1 8.51 8.51
MANUFACTURER 091447
2WY59 TOILET SPUD, FULL OPEN,1 112 X 1 1/2 IN 1 7.04 7.04
MANUFACTURER 091367
NUMBER OF PKGS: 0 WEIGHT: 0.88 INVOICE SUB TOTAL 15.55
DATE SHIPPED: 12/09/2008
CARRIER: UPS GROUND
TRACKING NO: 1Z6533410392359080
These items are sold for domestic consumption in the United States. If exported, purchaser assumes full
res for complian with US expert c
PAYMENT TERMS NET 30 DAYS. PAY THIS INVOICE NO STATEMENT SENT. PAYABLE IN U.S. DOLLARS. AMOUNT DUE 15.55
SALES, FREIGHT AND WARRANTY TERMS AND CONDITIONS
ld ns*eld -�l U'rtor tic S.helftile. F."del 11 ci�stonle tiro 31%" :,Sr 1 'at r) ff�IrsL, I NO! -sil, S-qs� u
sl:iesS J_ o CiOltse1w
O
wholesale Only. I lli"It set f 'of lill' a
r E: qwr a a 1 u Q'! olmio s t= 11s:'i r c r a ccess to a G, I ig e ca log, if ralw; Or "jinsIt :rsS list cons-
Rv tv rnarke ierlies..nts t .it I i e 1 ,111 �,r. 'o nape ch
r.. :g all J le E
tute th" g lo jlllu t: 'I Vey t ra.n ;er Ill':, Gra rge G'awcleF the r,s o corteilt DLI�hslfkm Dljnl;f!iz� "d I fi; co 1,.1 V svit ',,oil wahle re a iflop
A,I helaO Ill tl� tPill 'pichh-t" sha.] sell )eoilm--1 Giairge, Electronic and photographic Cleaning Fluids Customers. It l viosition of federal layl to act, cisz`.bu.e, ur m to
Prices. Pie.cs i sffid arc no "Cu de fi2joht, 1'aliulhnl� 'lier, or Taxes :end are sLih 01 ii scsl cr dis, h i a. ch:ciofh:cicc�tr, ae, t;;I contai lro clecfflfrg f1jim i or
G e n I to 'a it rl c I l 0 a- 0 M I T 0 r C: ii Se r 0 s if r:) I 1. e Is I I "f a lly e: t i 1 1
I l g P 0; ri ark I I l's 1 i V P G o rn ri I c hy I e 'n s A is o'l accilrdhog to currf Ill O,, and p�ho ai� p j:. S C 1 0 a
librion ,an of uD In S2,_000 -i sAe Indiaducls p.,, s 'Ch proMil"Is fl
L-St pejj _t "lei C�onlycfa
Sales fix, t s fc m a t3cr6nsr`e for tax j or pfoli.chnn a vj; a sal-I tpx x. rlwtse cerufiqsP, si in acroioanwE vith 0 CFF
Payment Terms, CFO loor r�c'mts Ofick,, rhoreiv O t-, Vii; tt aez!e to I Sir,, A i nc.oi Express. Fur... mnin,s A C(Min I J r, al; de':fso Ill i tho 'lu .1psIPS 0 OerS,:;n that i: es t 11 e '0 j r g1 la s 0 S 1 t I s, I I eO<
G aricei c-duh, re )s I I Pt 30 dS1, l i Oro k I srorlt 0, Antic p i and or sills l' to at elk. CE'Soll Sins has '3", io J:C tollov,:ng derl tia"orl rurnbe a f 1-j""a rilts dR,T fie; J u 1)
O� 111S I ceflse nm -0". e" 'Iceri r;, "In
-as rl fillcmfocj o r d s ray ;a Lie CXon'. nay n' 1 c: M a l d Yl ;art self, Stat�. S tax �P�z ii i not on .9 r S
S a ff a," �Ini 'fior I iv s w lived, Refrigerant Customers. Fi ve 4. 1 ill f (c 'ne r Ai Ac sal o, as
f;ol arc. :I i;h; I ba mt.ri ros, L i, U Ve the ripht iet C
1, is ro,ii pay i vs i h n i s J, s '3o ger �i jp,', �is u i�d �uu F Yr?ot acs ,r way, A CFCs an (1 2 Ci C` rcfriil vi:l Oe lestficlef: to 'es L. p'l ?-d.fil lo SeTllre reiii
its upho :el all 0 a""' ;art o jrollpciec C!je" ^olails, .0 Dqj"llas qt,lsted cus if if oiesum a ca r, ,a
Credit Balance- 1 stcw r aqre tila� a ,f cr bil, ace(z I,c two m hil ain"llpo t1ir ill vea of :s ls jlowe. or le I he o I r bass_ S
PED Vfl REMAI IING ?S' LL EE SUBJ' C 1 3 Sourced Product. Gra roer I. ,v rfrocw rircd Or f c "r i j s h h 1fo g h 1 S I g e'
F -4 P I E D 0 P R, E2 J i N L I A, P. ANY BALANCE R _:il" or Or
ANCFI I A l' N, J`Ja_" GIRAINGE SHALL. Hi"Ov E L ABILH',. cull n a rost1--r ,M cater sFjuocs S C' r I G'Ofntief as" t, I
Freight Policy and Shipping Charges, `ro it s F cf bDi:si p,i t l lwi. ht r d uni qs 1;1�,, ?St or fnd� Sour,ed Pircd-c' ci pjjcPo according l, cijfen car�ot ccrwifior� icr s s:t;:afio, i
paid
Ic P "M :I I
by Grai,ifwi iwi (J argec lo k: JS orl ef, 0' 0 er 5
0, fi h: Jung an y b ckcr1els, e sh
i ar, ei C(J:l, Las Sjtl elfaCr is Sri, `�B Silif r ill ni �'v;�i g Its an no li-s �)lnc i l G'a nje� and pped I,eitjl't s
i f r If Zli rofv r r Dcif"ri outsio of the "Clilt 1-11 jc States fre, III res porls h:1 t" o' Tir
G D. sh1wn,"rits je- of per tree Olivir e :ris all -und.tiji nil, il for reign col'ec,� cl,foil Closers, haiodrufl C "i
sernffo
mal sp", ai hanol n." or shlpihe� 's I, I s ko 1 te c cl ri 1 s3; s I II i I roj s is A: i e xti Ila r: e in of �i' l n( I c i n e A i:v cha 'o: a d r r, cull s I i es, if c as (1
s s lateria s, �;us,om a n i r a. or
if I letV-(:,:Z, uc ps _slon S _i vier o ,oar a ri 3 o 1: 11 g I t t a r i a T. r r U'S r&d P r spe, A ani r
are point 91; cjsIomc i, -1s t
01h; ewopo Go cJs k cation. li'. 'SGA! rust I t Goa.nne� D j to
R _stcrrcl� :if and
rq', ct C-s o me cls:oee: Po: tenjo C sh illo Is -;e earlie r. is f,mr_lgec Ill trans ri jnrq ally
I rcd act. A uowg ill my a aii 1.
F -p y to ,n,, 'e no Sotimed pmeli Spec ze fl
Jens
1 Ia::i
muss fi :lJwl SJVi the so t e r. j 'I,u a'e SOL' )I, l� F NA Sf t:as s c 9 v aw no JOh'sp,,
e t jwjs, D c a,ii. GRA.INGFR'S STAN RO 'WA 7 FRMIS AS SE_ FORI 'i SO %107 APPI
GRAINGER LIMITED WARRANTY
0 Is 0 U R F F GT GRAII TI HE FUJ L S FXTP' RINIIT ED. PASSES T wish T o COSTOTAER ANY
LIMITED WARRANTY, i% L PRODUC IS S01 "Ah"IeFfil"Ji I by GR'%luli ONLY 0 "'US I 'IS OP Sio-F, A N D A �L rVANUFAC I "Pr R AND SU I P- LK PR DJ ',%/AqPAN I IES_'
i IN BI :S1 CR ';R:G INAL E riM T MANUFACTiFlE. AGAIl FFECTS (MANS 0. Poll ERR t S
UNDER �4�)KMAL ISE OR l_'1FE YEAR Al- i ER D A T E (N �uRCI PSL ROM GR A 0 R. ANY PR. DEE-EPTAINED ADDITIONAL TERMS
BY G ."AIN 0 6e 'j r E f IV' 'N r,1A 1 Tr I f 1 P 1 HL t f"HIF R I JRN I Cr `If r. 'Bf ll Force Male re (3la rce: sIra I "'A for 1 a in f r) rlei foil i" An n lole F
E:' SE CE L"I'ATI"N. AS PES!GNAJ G(Jz'-,TS 1 PEPA13 1 L.. BE AS I r t ci Cris,
LX q 'EF1 NDED fo j prod wna!es f I r"tenl!�, s _rsi "1 0 C 1,�. 0� ar ovw: ri's"w z! :ices or CRjse O�,
D 0 R A r G G, rl I A
U il REPA HE D "'R PE PAlf S OP UTC1
PRICE I,-
i; I I s coric z c� as bus� less
WARRANTY RISC LAIM ER. NO VJAB BAN fY C N A c' j', 0' FA l, 0R II P ED, 0T+ ills comtw
F 0 R H I I I F M I T D 01 A R R A sJ T Y S TA HIM 1 N AB'U'.. IS IS A, DE R A'J H 0 R 1 P BY (31"ING R, �RA NI-FR Product Substitution. stitution, P 1 1 1 l ie J'� j:I[ 1 es ti h' g f:e�c� rJO)"s arl�� S
F E
DiSc_'LAII`. AN
Y LIAB'_Ify FOR Pq� DL' EC F ARE LE MIS USE, tl ROPLP
F, T Ovs a L
:,cl n 1:1ficJ ,o 11, cro;
i.ic nJ ok.�e,C
F`, J' I Sri Of, OR ULSAPD! GiJMN, A AN EFSCR,� luki _FS N 0 T XF R r SIS On, `P: Y A iAARRf',N i I Cancellation, ruce al al.("l 'n- 5� m L"
TH. M IC AR l ljl�.RG AN G OP cIi FOR Sit AT, PURPO'�,F, Product Holum, !oU Ci h -r_ i :3
LIMITATI ON OF LIABILITY. ANY L ll I Ll f 'i I D Ff 'Ir, r_SEQ I E N AL, I N C )N A ScKifs_ L' H' 00 flt
Availability. I jllc .Oa, lot j 1�4,le a ^to
DAMAGES f X r F S S LV S A I fl'fm RA IN
M ALI NTI 1 11 PlND S L I Assignment riv Or R I ollr �%0n t "I" 'f� ww�,�l cons�_Jf f
EXCEED T `E PlII F PRIME R;',:') FOR T PHODUCT T� A �IIV�S RISE 0 ANY
Any al tia; I;"IFre os onrow tt G a n s o r s 1 ,no, ln-r "t, if la.: t"' G a fl, r to F jr e st 'r c."
lylailutaclorers' Warranty. Fc s:" Oi, uOI ;a"'I p'f)alz I Ojr toaro
a �368 3 S 6 4 19 Electronic Data Interchange. It I Sir ille. c r III C,js1 -1 hal's a,' repJ lo ue°e cil L C Ohs
Prompt DiSIO)%lVen, i nre: lw, 4 'l O`J,h off i. Ic, rem c oi o" w sai- sir 1;
Ch qysle 1 P 'rTaSe a cc ton 1smrs, ct n i t If et 1) w con e;
tf21 1
d rJ g ah" "'in m er, ""ri il I le sid Hlsu criq 4 u,r all EDT tolriaco (morr 0 c a; �el� n,') n:,st n fl�-
C J �C l 0 l) o'i vIl': 0�rv,� Bo 'o e e
t 'i �i,JA r� OUU`a�`., D. o' A j s 1: r, I I a 'fi3l 8649, gi,:rr, illi-, iwl
to a a i Isla he bound O'El-J)", Or !ill Ill, 'PoIn 1)1 'y cl c D "s l Ell
its t. zt
i de of, .::'CSt, cfntfo to 11h ll r hh; h"'s cl 0; P
le 1; s tns ill f -al -oo, l ip, r tha l .u j
Product Suita Ma iv ffa as wli kic"ilhies OCes ?Ild oo!l_ S:deS, DAIS RIC. 00, i t vra.e oO, ,ere no J w :"ai ladniec m forril. Goa ln. je a cf r1,1ccha:e I if acre., on tecii
il
C e
s'acrIa` a lef, Uh to use k. fra w LD: jtj oi -.le le s u t p
,:,O� of us,. o r� cjlX es i,. ce" a 11 l- Viel l-, �V" lio uf va it I[ iei
I o '.r is ar,is, VI re "'rainge a )'s K e �dw es I, cnc� D�
I(; re 11 Ja 1,,eri.cis cofr.o le Ill -e� con rrce, a cannot oe I o n s: th o f I P. so I d s r horyop- licceSs T e liu ,mess re Is ma waiw 1 Gra, rig e ega t n FP purcr3ses rl2de t'A
se
c-I
s it U Spk and I Fl ;Se o I O ,r, t fj i(;l lop fl,
a 1 11 11 IS 1)
if; .Pl
aw 'Ila: in-,- I 1, Modification of Terms. G aoige ac f):' any order is 0 C sn,Mel S s.1 a, t ool c 'c
sate ring.
iw oi'l 1 cul" ii -ii,
No Warrant hi Consumers ps, v.; rt W ..m c.effiFled a tvlacilw;op NViss ccnolli-rc, se .11 GIain(j. ac.lmov. alo assent to t s. n, and shaJ te
Dresumoo '-or orate we P_;l�rl of Graw:g frorfl W at of ffflv )z; �7f
PRODUCT INFORMATION vie t ocs of sc,vice, crd NO acifit cr f f fah fen rf t old Cord'h3 ho 1 i lp lji3Ohng u Srli-il
;19 I, lej G ei!igi:h Ili hi if A;o hil-E. crd,3i or 'tf Corr Soon&ll'1c (""'l 11 of cond fir n,°
OSHA Hazardlirs Substance. a at Sli--t iM` 0 F A defhr F,,wJoij sl btanc oyll Oif
COnI m l s Ou: onrlhim" coluar
l ej l Gra,ngp ssknovj iiAiifenl, Gra. t t a y :s,r sr: I
pa:eo ar.j s i-ip.wc i n h e cot S tip I as �k al', J1(W;'Wlj INPlS 3eli cons tioli i w iiii ma[ cans t. ,;a: we a G nger O� Or;
ug n:� I iq lfc�eql;1:_r d tec,. �i.lierja`rna crorWi- ii� MSEs arla he evi"(
iC he alc:Ale. 6r,fig-, tllov ul',kes sea e, 11, �.f it ,he elo n 'he I t atiol I 'le
uiLal lav o! hic rel is S f�_nullc I, -1� 'j 1�l d.: jr 11'e n* n f1cill' ahijil, am, fit �la aic ccwfllofif rtar m if G
Cl
t if it is folrc jociel as is ll'afilria:s hso�,'
l 1 c of ally r (j
rofc,* )o
r r �fl- f I t., J� Materials of Trade, ,t filiner eoresenl; 4ha spic, hl J 1:
if T ti of f "Cje 01 fenor Sequ aul S h a'. tc J 1 lue use i r f
California Proposition 65. 71- e S tYlIfIll 0 cu a.. I'll"I
I o p, j qq c I i .1
S ;Ppol 0; "s Irl'SIO S l h is no _rn ispr tahor, ar"I 11 1a su s. 0a.1 not he te o c r tinns; n a
f, rl-li" r); 6 Fir ,c leis 1 0 of 0 s orl",i I oI:Ov'Ig wlrq l is 1, 2
0 V rll 1 t rU tf cofhsi, orcouc tans vm t U S of
Z
a (TE"N ca! Waiver, Chonie of Low and Venue. t�c 'a e st ei f tv liOrl ha'EHl e' M J ;IUS, JDfAl (V Os'�,
'i 0" 'Sale of C-a.iho'.Ilst 1�i n drf ill ?I
2," tt�f r� en� thcr 'I" of lkat iv'Jif e�cuse a;i, S Or ro�waric I
f I liw I rl� ill rlpi
Or% �l fl� O'c' o s
lj
j cj", ei C ::al nrl I 8 -5 35 1 S
Important Notice to Federal Cushollio", Re: Country of oligoi. iis ,ict li G'S"A Ad.vamaoel l "lle 140 Third Party siolpfit r a e e th 1s J'-fl it t:
r�; i ce 1 cf I if T we llruy -r at T iis I w h l P;:r. 2b, o u, ma v lr,;l ru;,, ffiese OE'llt, is 01 C,i:, 's Milil oiy moS 1 v tY "Of a part, Icl.;.
r eap; ir), ncl.r vT ad'ise Ir �W ;c E ae ""iedWe �;haseis s; t Complete Agree inent, i hP e r ms al J f,o J ouns I" ir, s tol ims, ol jiln c is, ilwo:
the !Mle �f pu"ch,'se art t n ie Cus':ylifiis s; o I wcha! iu" d. m o, I he and catalog sils I and creitubor l'o nccip5!a'Po Ia*e;: aid the entire and
the rax;,ficn.t. i r,hr.,a an ?I or )-TAA ;?iS I d.n ini!rf a„o
2R493 'D1
1
i\
tPrescr;Ad 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
2 T �L,/9� 4f¢ Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�O S� bill(s) is (are) true and correct and that the
y Y 0 UL materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
01...1_
Title
Cost distribution ledger classification if Director of Golf
claim paid motor vehicle highway fund