171785 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 054300 Page 1 of 1
.F ONE CIVIC SQUARE CENTRAL SUPPLY CO, INC
CARMEL, INDIANA 46032 PO BOX 1982 CHECK AMOUNT: $236.81
INDIANAPOLIS IN 46206
CHECK NUMBER: 171785
CHECK DATE: 4/29/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 4645603 236.81 REPAIR PARTS
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ENTRA.L SUPPLY COMPANY, INC.
tiu p 4f2a/ 09
Central ly I nd.cl Ce;ntr�l Sup lt� €nat� o o :4f�4 5643
P 3 BOX 1982 r Ge'n tral Supply C �a r 21.14;14,
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INDIANAPOLIS, IN r„ I da:°ana;ptali4�, �•:L4�, �,4�21�,'
o y ORIGINAL
CARMEL SIRE €?EFT
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o '2 CIVIC` SQUARE i C..I VIC y:SQUAf2E,�
D CARMEL 11V CARMEL,
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L_YNBROOK
i Taxab N Terms 1.
Payme of Due On If Paid By Yau Owe_
4cS45603 236.81 5/31/09 5/10/09 234.
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rth Service Charge will be made on as AMOUNT 2 36. 8 j
ts. We hereby certify that thes ggoods
s o sections 6� 7 and 2 of the FaPr Labor TaX ct as am and of reege lati 1 L b d N e Unite tates Depart nt o a or er Section 14 thereof.
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EXCLUSION OF WARRANTIES: The factory warranty cinstitutes the only warranty with respect to these goods. Seller and Purchaser hereby agree that the implied
warranties of MERCHANTABILITY and fitness for a particular purpose and all other warranties (except for the factory warranty), express or implied, including any
warranties made by affirmation, promise, description or sample, are EXCLUDED from this transaction and shall not apply to the goads sold. 2.?. S
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))
4645603 Replacement Urinal $236.81
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 N
ALLOWED 20
Central Supply Company, Inc.
IN SUM OF
P.O. Box 1982
Indianapolis, IN 46206
$236.81
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 4645603 42- 370.00 $236.81 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
APP 2 7 2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund