178692 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 117265 Page 1 of 1
ONE CIVIC SQUARE G.W. BERKHEIMER CO, INC
INDIANA 46032 PO BOX 1247 CHECK AMOUNT: $101.00
CARMEL
PORTAGE IN 46368 -9047
CHECK NUMBER: 178692
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 77652 101.00 MATERIALS SUPPLIES
ar
J 0 C a WHOLESALERS
Co o 9
AIR CONDITIONING C HEATING REFRIGERATION
BRANCH
SOLD TO CITY OF CARMEL 4 EAST COLLEGE DRIVE
760 3RD AVE SW ARLINGTON HTS It 600042553
SUITE 110
CARMEL IN 46 C32000C
SHIP TO CARMEL WASTEWATER PLANTJIE FFJ
9609 HA2ELL DELL PKW PLEASE REMIT TO
INIANAPOLIS IN 462800000 P O BOX 1247
SHIPMENT# 5-745804-Cl 83 3 PORTAGE IN 463689047
T. CODE NO. YOUR ORDER NO. INVOICE NO. INVOICE DATE
21448 1t3 JEFF 077652 10 12 09
1 1 SHIPPING CHARGES 6.84 6.84
65753 1600- 868CRP 1600- 846C'RP 170ORP KI 94.16 94.16
TAX EXEMPTION CODE: IN 00312015547 NO SALES TAX
PAST DUE INVOICES
4WSUBJECT TO A 2% SERVICE CHARGE
ALLOWABLE IF PAID BY 10TH PROX, NET 11TH ORIGINAL IN=CE
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
117265
G.W. BERKHEIMER CO„ INC. Purchase Order No.
u
P.O. Box 1247 Terms
Portage, IN 46368 Due Date 10/19/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/19/200,( 77652 $101.00
f
c
t�.
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
VOUCHER 096604. WARRANT ALLOWED
1
117265 IN SUM OF
G.W. BERKHEIMER CO., INC.
P.O. Box 1247
Portage, IN 46368
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
a
Board members
PO INV ACCT AMOUNT Audit Trail Code
77652 01- 7202 -06 $101.00
F
Voucher Total $101.00
Cost distribution ledger classification if
claim paid under vehicle highway fund