204044 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 316200 Page 1 of 1
ONE CIVIC SQUARE UTILITY SUPPLY CO INC. CHECK AMOUNT: $589.61
CARMEL, INDIANA 46032 6310 S HARDING ST
INDIANAPOLIS IN 46217 CHECK NUMBER: 204044
CHECK DATE: 11/21/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1048583 589.61 OTHER EXPENSES
INVOICE
�W UTILITY SUPPLY COMPANY
T Branch: 03 USC NW INDY INVOICE
6310 SOUTH HARDING STREET 1048583
c' INDIANAPOLIS, IN 46217 Invoice Date E Page
US 10/20/2011 12:23:00 1 of 1
ORDER NUMBER
317- 783 -4196 1051814
Bill To: Ship To:
CARMEL WATER DISTRIBUTION CARMEL WATER DISTRIBUTION
3450 WEST 131ST STREET 3450 WEST 131ST STREET
CARMEL, IN 46074 CARMEL, IN 46074
US US
Attn: K LOVEALL Ordered By: JEFF CARPENTER
Customer ID: 100753
PO Number Term Description Net Due Date Disc Due Date Discount Amount
106TH COLLEGE IWC CHANGE ORDER Net 30 DAYS 11/19/2011 11/19/2011 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
10/17/2011 13:58:09 1053248 ANDY NUGENT RROPES
Quantities pricing
Item ID U0A1 Unit Extended
UOM h Item Description price Price
Ordered Shipped Remaining Unit Size p Unit Size
Carrier: OUR TRUCK Tracking
1.00 1.00 0.00 EA 16FA EA 376.4118 376.41
1.0 16" FOSTER ADAPTER WITH ACCESSORIES 1.0000
FREIGHT NOT INCLUDED IN QUOTED
PRICE
4.00 4.00 0.00 EA 391906 EA 27.5000 110.00
1.0 16" MJ BOLT GASKET KIT 1.0000
20.00 20.00 0.00 FT 8CULVERT FT 1.9227 38.45
1.0 8 CORRUGATED SOLID DRAIN TILE PE 20' 1.0000
Total Lines: 3 SUB- TOTAL 524.86
Total Freight In: 64.75 "Total Freight Out: 0.00 TOTAL FREIGHT. 64.75
TAX: 0.00
A FINANCE CHARGE computed at a periodic rate of 11/2 per month (I S AMOUNT DUE: 589.61
ANNUAL PERCENTAGE RATE) is applied to PAST DUE ACCOUNTS OVER 30 DAYS.
ORIGINAL
VOUCHER 112901 WARRANT ALLOWED
316200 IN SUM OF
Utility Supply Company
6310 South Harding Street
Indianapolis, IN 46217
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
0�
1048583 A9- 1050 -66 $589.61
Voucher Total $589.61
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
316200
Utility Supply Company Purchase Order No.
6310 South Harding Street Terms
Indianapolis, IN 46217 Due Date 11/1/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1111/2011 1048583 $589.61
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 cer