166869 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 362255 Page 1 of 1
ONE CIVIC SQUARE S K ACQUISITION GROUP CHECK AMOUNT: $93.46
CARMEL, INDIANA 46032 DEPT 4830
PO BOX 87618 CHECK NUMBER: 166869
CHICAGO IL 60680 -0618
CHECK DATE: 1211012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO DESCRIPTION
651 5023990 518587901 93.46 OTHER EXPENSES
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FDIC NO. 06- 1621369
I r S &K ACQUISITION CORP. REMIT TO: S K Air Power
dba S K AIR POWER Dept. #4830
5864 W. 71ST ST. P.O. Box 87618
INDIANAPOLIS IN 46278 Chicago, IL F
60680 0618
INVOICE NUMBER
CAR550 9002 5185879 -01
317- 371 -2443 CERTIFIED
BILL CITY of CARMEL UTILITIES SHIP CARMEL WASTWATER TREATMENT PL.
TO: 760 THIRD AVENUE SW TO: 9609 HAZEL DELL PARKWAY
CARMEL IN 46032 INDIANAPOLIS IN 46280
CUSTOMER P.O. NO. CUSTOMER P.O. NO. S 1 1 437
INVOICE NUMBER SLSMN. ORDER DATE TAKER CUSTOMER P.O. NUMBER DATE
5185879 -01 505 11/25/08 556 511437 1210.1108
INSTRUCTIONS FRT. PAGE NO.
*SHIP TO CUSTOMER* X 1
QUANTITY. ITEM CODE AND DESCRIPTION UIM UNIT PRICE AMOUNT
ORDERED BO.IRET. SHIPPED DISP.
1 1 *ASTECH 28007 EA 32.66 32.66
1/4" X 50 ROLL PIPE JOINT
Z TAPE
ITEM #1
NS 11437 A
1 *ASTECH 28014 EA 32.66 32.66
1/2" X 50' POLY TEMP
JOINT SEALANT
o ITEM #2
ICP
NS 11437 B
1 1 *ASTECH 19093 EA 7.80 7.80
3/32" X 20' POLY TEMP BSP
ITEM #3
NS 11437 C
2 2 *ASTECH 34224 EA 7.60 15.20
READY STICK LUBE
ITEM #4
I rrl NS 11437 D
CODE EXPLANATION THIS IS YOUR INVOICE SUB TOTAL 88.32
STATE TAX APPLICABLE C CONSIDER COMPLETE
FEDJOTHER TAX APPLICABLE D DIRECT SHIPMENT FREIGHTIN FREIGHT OUT MISC. CHARGE
i STATE 6 FEDERAL TAX APPL F FACTORY MINIMUM
B BALANCE BACK ORDERED n RETURNED CYL TELE. CHARGE
0.00 5. FREIGHT TOTAL 5 .1 4
FEDJOTHER TAX
NET TERMS: INV 3 0 DUE: 12 STATETAX
ORDER COMPLETED PAYMENT REC'D. 0.00
TOTAL AMT DUE
ORIGINAL 93.46
I
VOUCHER 086869 WARRANT ALLOWED
T1057
IN SUM OF
S K ACQUISITION CORP
DEPT #4830
PO BOX 87618
CHICAGO, IL 606 -0618
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
518587901 01- 7202 -06 $93.46
%;A
V
Voucher Total $93.46
Cost distribution ledger classification if
claim paid under vehicle highway fund
I
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
T1057 s
S K ACQUISITION CORP Purchase Order No.
DEPT #4830 Terms
PO BOX 87618 Due Date 12/8/2008
CHICAGO, IL 60680 -0618
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/8/2008 518587901 $93.46
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 Officer