168847 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 00353173 Page 1 of 1
ONE CIVIC SQUARE A F C INTERNATIONAL INC
6 CHECK AMOUNT: $529.13
CARMEL, INDIANA 46032 PO BOX 894
715C SW ALMOND ST
CHECK NUMBER: 168847
DEMOTTE IN 46310
CHECK DATE: 2117/2009
D EPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION
651 p 5023990 27436 529.13 OTHER EXPENSES
AFC International Inc Invoice
PO Box 894
715C SW Almond St
,F N A INC DeMotte, IN 46310 Date Invoice
1/15/2009 27436
Bill To Ship To
Carmel Waste Water Treatment Plant Carmel Waste Water Treatment Plant
Attn Accts Payable Attn Jeff Cooper /S11474
760 Third Ave SW 9609 Hazel Dell Pkwy
Suite 110 Indianapolis IN 46280
Carmel IN 46032
P.O. No. Terms Due Date Rep Ship Via
S11474 Net 30 2/14/2009 CES 1/15/2009 UPS
Qty Shipped B/O Cat. No. Description Price Amount
4 4 0 008 3012 -150 15' Tygon tubing w /male Luer 42.24 168.96T
fitting (QRAE /QRAE
PlusNRAE)
1 1 0 58 -450 58 Liter 4 gas mix, 100 ppm 170.00 170.00T
CO, 50% LEL Methane, 25
ppm H2S, 20.9% 02, balance
Nitrogen
1 1 0 34 -413 Cal Gas 50% LEL, 50 PPM 144.50 144.50T
CO, 10 PPM H2S, Air
1 1 0 Hazardous Hazardous fee 28.00 28.00T
1 1 0 Shipping Shipping Insurance 17.67 17.67T
Charges
Tracking No
Iz6e51330370476161
Subtotal $529.13
Thank you for your order. We appreciate your business. If you have any
questions, please contact us at 1- 800 952 -3293 or fax 219 987 -6826. Sales Tax (0.0 $0.00
Returns subject to restocking charge. No returns will be accepted without
authorization number. Total
$529.13
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
00353173
AFC INTERNATIONAL INC Purchase Order No. l
PO BOX 894 Terms
DEMOTTE, IN 46310 Due Date 219/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/9/2009 27436 $529.13
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
V6UCHER 095002 WARRANT ALLOWED
00353173 IN SUM OF
AFC INTERNATIONAL INC
PO BOX 894
DEMOTTE, IN 46310
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
27436 01- 7202 -06 $511.46
27436 01- 7202 -06 $17.67
o
1
Voucher Total $529.13
Cost distribution ledger classification if
claim paid under vehicle highway fund