174834 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 361032 Page 1 of 1
0 ONE CIVIC SQUARE DYNA SYSTEMS
CARMEL, INDIANA 46032 P 0 BOX 971342 CHECK AMOUNT: $114.47
DALLAS TX 75397 -1342
CHECK NUMBER: 174834
CHECK DATE: 7122/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1207 4238000 20274786 114.47 SMALL TOOLS MINOR E
Dyna Systems SHIP TO I11VOICe
P.O. Box 655326 �BROOKSHIRE GOLF CLUB
Dallas, 7X 75265 -5326
(800) 336 -0450 RUSSEL PICKETT 1 of 1
12120 BROOKSHIRE PKWY
NCH Corporation CARMEL, IN 46033
g pp1 Ac
e
`O q-
BILL TO N
REMIT TO: PO BOX 971342 o�
BROOKSHIRE GOLF CLUB DALLAS TX 75397 -1342 �e Ntlmi0
BOB HIGGINS "Distribution services include shipping and handling
12120 BROOKSHIRE PKWY charges. Returned merchandise not accepted without
CARMEL IN 46033 return goods authorization. All return claims for errors
or adjustments of any kind must be made within 15
days after receipt of goods.
INVOICE INVOICE DATE CUSTOMER CUSTOMER P/0 DUE DATE
20274726 06/24/09 DY305524 ;SEL 07/24/09
ORDER SHIP DATE SALES REP RELEASE SHIP VIA
20226173-1 06/24/09 D202 D202!6146 FED EX GROUND
FOR REORDERS CALL 1 -800- 336 -0450 FAX 1- 972 721 -6870
PAE3T IVE ...;.1JESCRIF'T10N /SIZE f'KG iOTY E3�D. I ,Ol1fi SHP,.,? UNIT:PRlCE E7ET AIvI0U1�7;,;>
DY00421341 CAP SCREW SIX SHOOTER EA 0 50 17.60
DY00422137 CAP SCREW SIX SHOOTER EA 0 30 15.04
DY00422141 CAP SCREW SIX SHOOTER EA 0 30 17.38
DY01981700 NUT GR8 HEX USS USAXAN M EA 0 100 27.74
DY03481700 WASHER SPLIT LOCK EA 0 100 5.29
DY01981300 NUT GR8 HEX USS USA /CAN M EA 0 100 19.84
DY20139413 EASY DISCONNECT MALE BLUE EA 0 50 25.05
SUB -TOTAL DISCOUNT MIN ORDER CHG SALES TAX *SHIPPING TOTAL
127.94 25.60 0.00 12.13 AMOUNT 114.47
TO INSURE PROPER CREDIT, PLEASE DETACH HERE AND MAIL BOTTOM PORTION WITH YOUR PAYMENT.
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.
�0 4 Terms
!Dw as t-�)42_ Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
N?'10)A0 L01
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
IN SUM OF
0
L A 113
a�
ON ACCOUNT OF APPR OPRIATION FOR
in,
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
1 bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
6v� Si utur
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund