176127 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 00350745 Page 1 of 1
ONE CIVIC-SQUARE ASSOCIATED BAG COMPANY CHECK AMOUNT: $208.99
CARMEL, INDIANA 46032 Po Box 3036
MILWAUKEE WI 53201 -3036 CHECK NUMBER: 176127
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER INV NUMBER AMOUNT DESCRIPTION
1120 4239099 Y572834 208.99 OTHER MISCELLANOUS
400 W. BODEN ST. PHON 800 -926 -6100
Associated MILWAUKEE, WI 53207
FAX: 800 926 4610
550 LILLARD DR,
SPARKS, NV 89434
Company 4039 ROCK QUARRY RD. FOR BILLING INQUIRIES
DALLAS,TX 75211 PHONE: 800 926 4613
Packaging Shipping Supplies 14 E. MAIN ST. FAX: 800- 760 -2348
NEW KINGSTOWN, PA 17072 www.associafedbag.com
Flo I�- p o U �Q `�6,fM Cm° OM o o SELLER'S PERMITS
129507 CA SC OHA 97523195 PA 82262922
IL 1951 -0421 TX 13907429891
M N 3864223 Wd 004- 0000490095 -01
REMIT TO: P.O. BOX 3035, Milwaukee, WI 53201 -3036 NV 1002029627 PAGE: 1
SHIPPED
TO
CITY OF CARMEL CITY OF CARMEL
SOLD FIRE DEPT FIRE DEPT
TO 2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL IN 46032 CARMEL IN 46032
USA USA
CUST OMER ORDER DATE REQUIRED. BUYER: GARY CARTER
GARY CARTER PHONE: 317- 5712667
,Z..O,1�4FZ�IGHT TERMS
08 03 2009 Y572834 FTGROUND PREPAID ADD NET' 30
ORDERED SHIPPED. B/O STOCK NUMBER/DESCRIPTION UNIT PRICE
2 2 0 71 -8 -38Y 90.600 50 /CT 181.20
36X48 6MIL YELLOW OPAQUE POLY LINER
NON TAXABLE TAXABLE SHIPPING TAX RATE TAX
181.20. 0.00 27.79: 0.00 70 0.00 D 208.99
WE HEREBY CERTIFY THAT THESE GOODS WERE PRODUCED IN COMPLIANCE WITH ALL APPLICABLE REQUIREMENTS OF SECTIONS 6, 7, AND 12 OF THE FAIR LABOR STANDARDS ACT, AS AMENDED,
AND OF REGULATIONS AND ORDERS OF THE UNITED STATES DEPARTMENT OF LABOR ISSUED UNDER SECTION 14. HAVING NO CONTROL OVER THE USE OF THE ABOVE PRODUCTS, WE ASSUME NO
LIABILITY CONNECTED WITH THEIR USE. UNDER NO CIRCUMSTANCES IS ASSOCIATED BAG COMPANY LIABLE FOR ANY LOSS, DAMAGE, OR EXPENSES ARISING OUT OF THE USE OF OR INABILITY ORIGINAL INVOICE
TO USE OUR PRODUCTS.
Please detach and return with payment REMITTANCE COPY
REMIT TO: P.O. BOX 3036, Milwaukee, WI 53201 -3036
or pay online at www.associatedbag.com
NAME ACCOUNT INVOICE INVOICE DATE
CITY OF CARMEL 129507 Y572834 08 -03 -2009
NON TAXABLE TAXABLE SHIPPING TAX RATE TAX o�•',(l,�o�j
181.20 0.00 27.79 0,00 0.00 208.99
Associated
a'l-q Company
1000- 570 -0512
(rev 1/08)
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Y572834 $208.99
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5-11- 10 -1.6
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Associated Bag Company
IN SUM OE$
P.O. Box 3036
Milwaukee, WI 53201 -3036
$208.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 Y572834 42- 390.99 $208.99 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
AUG t 2099
V _e
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund