200674 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 316200 Page 1 of 1
ONE CIVIC SQUARE UTILITY SUPPLY CO INC.
CHECK AMOUNT: $516.45
CARMEL, INDIANA 46032 6310 S HARDING ST
INDIANAPOLIS IN 46217 CHECK NUMBER: 200674
CHECK DATE: 8/17/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1040800 516.45 OTHER EXPENSES
INVOICE
UTILITY SUPPLY COMPANY
,,,TTT Branch: Ol USC INDY INVOICE
Y 6310 SOUTH HARDING STREET 1040800
INDIANAPOLIS, IN 46217 Invoice Date Page
K us 7/28/2011 16:13:35 1 of I
ORDER NUMBER
317 783 -4196 1044276
Bill To: Ship To:
CARMEL WATER DISTRIBUTION CARMEL WATER DISTRIBUTION
3450 WEST 131 ST STREET 3450 WEST 131 ST STREET
CARMEL, IN 46074 CARMEL, IN 46074
US US
Attn: K LOVEALL Ordered By: GREG HOLLANDER
Customer ID: 100753
PO Number Term Description Net Due Date Disc Due Date Discount Amount
GREG -7 /28/2011 11:45:03 Net 30 DAYS 8/27/2011 8/27/2011 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
7/28/2011 11:44:11 1044797 ANDY NUGENT BNEYER
Quantities Pricing
Item ID UOM Unit Extender)
Ordered Shipped Regiaining UOM y Item Description Price Price
Unit Size C Unit Size
Carrier: CUSTOMER PICK UP Tracking
1.00 100 0.00 EA 6MJSG EA 12.4179 24.84
1.0 6 MJ SPLIT REPAIR GLAND 1.0000
1.00 2.00 0.00 EA 6MJBOLTKIT EA 15.1493 30.30
1.0 6 MJ BOLT GASKET KIT (NO GLAND) 1.0000
1.00 1,00 0.00 EA 226 069020 -000 EA 407.1500 407.15
1.0 6 X 20 SMITH BLAIR 684 -724 1.0000
REPAIR CLAMP
1.00 1.00 0.00 EA 4MJPLUGD EA 42.0571 42.06
1.0 4 MJ PLUG DOMESTIC 1.0000
1.00 1.00 0.00 EA 4MJB0LTKIT EA 12.1045 12.10
1.0 4 MJ BOLT AND GASKET KIT (NO GLAND) 1.0000
Total Lines: 5 SUB TOTAL: 516.45
TAX: 0.00
A FINANCE CHARGE computed u a periodic rate of 1 1/2 %per month (18% AMOUNT DUE 51.6.45
ANNUAL PERCENTAGE RATE) is applied to PAST DUE ACCOUNTS OVER 30 DAYS.
ORIGINAL
VOUCHER 111982 WARRANT ALLOWED
316200 IN SUM OF
Utility Supply Company,
6310 South Harding Street
Indianapolis, IN 46217 QQ
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
i
1040800 01- 6200 -06 $516.45
Voucher Total $516.45
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.
Payee
316200
Utility Supply Company Purchase Order No.
6310 South Harding Street Terms
Indianapolis, IN 46217 Due Date 8/8/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/8/2011 1040800 $516.45
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