156332 02/06/2008 CITY OF CARMEL, INDIANA VENDOR: 292700 Page 1 of 1
ONE CIVIC SQUARE STATE CHEMICAL MFG CO
j
CARMEL, INDIANA 46032 No aox 7 41e9 CHECK AMOUNT: $469.96
o� CLEVELAND OH 44194.0268 CHECK NUMBER: 156332
CHECK DATE: 21612008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4238900 93654938 469.96 OTHER MAINT SUPPLIES
World Headquarters PAGE: 1
3100 Hamilton Avenue
sl =p iai, Cleveland, Ohlo 44114
800- 782 -2436
State Chemical is a Division of State Industrial Products
01/14/2008
Cl�sromer.P.� info. ..Order N tJelivsr Nit:< Document T' e .Inirbica Na.
JEFF BARNES 3026826 83574036 Invoice QM1 93654938
GEstomer. No Safest ode;: Faxatsle All tax exempt customers Due:: DAYS
must submit tax exempt
21236 90140005 N certificate with payment. 01/29/2008
Your Sales Associate CAROLYN ROWE IS IS 155011 4001 04001 0!
Certified
BILL TO: SHIP TO:
CITY OF CARMEL CITY OF CARMEL
CITY HALL CITY HALL
1 CIVIC SQUARE 1 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
O t
Of
Sht L3nIt Extended
Qty
Descripttott NEiDS I*ice
2 CS 18072 SCRA:1 LIQUID ..PE C TNEn CT 12 21 5.000 430.
TH K ZOU FOR YOUR ORDER.
TO FEORDER CALL CAR LYN AT 1- 800 323 -4124 E T'2190.
1. IMPORTANT: Please return remittance portion
of invoice with your payment. To assure
proper credit to your account, ALWAYS Net Sales Shi pin &l'rocessin Sales Tax TOTAL
include your customer number, invoice number,
and amount paid with your remittance. 430.00 39.69 0.00 469.69
2. All shipments FOB nearest warehouse.
3. Claims for shortage or damaged goods must
be made within 5 days aftei receipt of goods. We hereby certify that these goods were produced in compliance with
4. No returns without written authorization. all applicable requirements of Section 6, 7 and 12 of the Fair Labor
5. If you have any questions regarding this Standards Act as amended, and of regulations and orders of the United
invoice please contact us at 1- 800 -782 -2436. States Department of Labor issued under Section 14 thereof.
FED. TAX I.D. N0, FOR CHEMICAL EMERGENCY SPILL,
34-0552740 PAY NO MONEY TO AGENTS LEAK, FIRE, EXPOSURE OR ACCIDENT
CALL C:HEM T REC DAY OR NIGHT
(800) 424 -9300
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
The State Chemical Mfg. Co. Purchase order No.
E
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9 3316 1 0 4 _93 E Sul ell I I liquid pip opener $469.96
Total $469.9
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
VOUCHER NO. WARRANT NO.
02/04.,/0.8
ALLOWED 20
The State Che Mfg. Co.
IN SUM OF
P.O. Box 74189
Cleveland, 44194 -0268
$469.96
•4
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
D or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
93654938-- $46 .96 materials or services itemized thereon for
which charge is made were ordered and
received except
20
i nature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund