161093 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 292700 Page 1 of 1
\Mf ONE CIVIC SQUARE STATE CHEMICAL MFG CO
0 PO BOX 74189 CHECK AMOUNT: $197.21
ARMEL, INDIANA 46032
CLEVELAND OH 44194 -0268 CHECK NUMBER: 161093
CHECK DATE: 6125/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1205 4462000 93817142 197.21 OTHER STRUCTURE IMPRO
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orld Headquarters PAGE: 1
310O H
3100 Hamilton Avenue
sio�e 7971 Cleveland, Ohio 44114
800- 782 -2436
State Chemical is a Division of State Industrial Products
06/10/2008
Gusriimer P.C). No, Order. Na Oeliver Nxi [7ocEirnent T e Invoice Na.
JEFF BARNES 3157779 83721950 InvoiceI 93817142
Ctitamer >No Safesi ode::
axatrte All tax exempt customers tee E p Due:: Date
must submit tax exempt
21236 90140005 N certificate with payment. 06(25/2008
Your Sales Associate CAROLYN ROWE IS IS IS 0014001 4001 01
BILL TO: SHIP TO: Certified
CITY OF CARMEL CITY OF CARMEL
CITY HALL CITY HALL
1 CIVIC SQUARE 1 CIVIC SQUARE
CARMEL, IN,46032 CARMEL, IN 46032
Open Ord
Ship i3i1,t Extentfed
Qty tOty fl1y Ulm ]tech Descript�Dr1 Pu ce. F'rlce
V i 'I GS 1u43U2 DUMP -STAR EAl2 181.000 Y4 181.00
THAISK fOU FOR YOUR ORDER.
TO FEORDER CALL CAR LYN AT 1- 800 323 -4124 E T 1101.
1. inaoORTAniT• PleagA return ernittance port_i ^n
of invoice with your payment. To assure
proper credit to your account, ALWAYS Net Sales Shippin &Pmcessin Sales Tax TOTAL:::..
include your customer number, invoice number,
and amount paid with your remittance. 181 16.21 0.00 197.21
2. All shipments FOB nearest warehouse.
3. Claims for shortage or damaged goods must
be made within 5 days after 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. NO. FOR CHEMICAL EMERGENCY SPILL,
34- 0552740 PAY NO MONEY TO AGENTS LEAK, FIRE, EXPOSURE OR ACCIDENT
C1 LL I,H L1Vi I EC DA Or, Ni6r i
f (800) 424 -9300
"prescribed►,r State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
-0-6/10108 9 1 3J O U 1 1 7 1 1. Dump-star $197.21
Total
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.
ALLOWED 20
:_T State Chemical Mfg. Co. IN SUM of
P.O. Box 74189
Cleveland, OH 44194 -0268
$197.21
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1205 Administration
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
2 materials or services itemized thereon for
1285 93817142 820 -7TU-r-- which charge is made were ordered and
received except
20
l
S,i natur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund