158028 04/01/2008 CITY OF CARMEL, INDIANA VENDOR: 00352515 Page 1 of 1
0 ONE CIVIC SQUARE MADISON FILTER
CARMEL, INDIANA 46032 PO Box 236 CHECK AMOUNT: $1,035.00
SKANEATELES FALLS NY 13153 -0238
CHECK NUMBER: 158028
CHECK DATE: 4/1/2008
DEPARTMENT ACCO PO NU INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 511071 181652 1,035.00 BELT DEWATERING
V
0 4563 Jordan Road
W P.O. Box 238 SALES INVOICE
✓i g 4•h.
Skaneateles Falls, New York 13153'
a USA
W Tel: 1 315 685 3466 INVOICENO f INVOICE DATE
l Tel: 1 800 637 6206
Fax: 1 315 685 5574
W
F Email: info @madisonfilter us.com
W
e Website: www.madisonfilter.com
SOLD BILL TO: SHIP TO:
CARMEL WWTP CARMEL WWTP
9609 HAZEL DELL PARKWAY 9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
REMARKS:
CUSTOMERPO�NO t ORD DAT CUST011IER NO ORDER SALES PERSON
S11071 02/22/08 3087 134070 SCOTT MISHLER
MR r
SHIl'YI A 5 N FOB TERMS OFFSALE""" OUST TYPE Wii
w H
r
NEWPENN PREPAID SHIPPING POINT NET 30 DAYS 5 1
a N A
ORDERED„ SHIPPED BACK ORD q ITEM NTJ1V[BER� I)ESCk TIO UNIT PRICE AMOUNT
W /POLYURETHANE SEAM PROTECTANT
EA WEIGHT 111 Q# 23321
PROD 326 1340701
BELT NO. 91483
TRACKING NUMBERS
71967003 -6
SUBTOTAL $1035.00
4 REM[T PAYMENT ONLY TO
was MISC. CHARGES $0.00
MADISON FILTER, INC. TAX $0.00
P.O. BOX 32196 FREIGHT $0.00
HARTFORD, CT 06150 -2196
INVOICE TOTAL $1035.00
z �����ORIGIN �,KII3VOIC8
VOUCHER 085110 WARRANT ALLOWED
352515 IN SUM OF
MAQ,ISON FILTER
P.Q. Box.- aayl,yb C-T
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
181652 01- 7202 -05 $1,035.00
Voucher Total $1,035.00
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
352515
MADISON FILTER Purchase Order No.
4563 Jordan Road Terms
P.O. Box 238 Due Date 3/18/2008
Skaneateles Falls, NY 13153
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/18/2008 181652 $1,035.00
that the attached invoice(s), true t I
hereby certify t ce(s), or bills) is (are) and
a
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 �y
Date Officer