173732 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 357536 Page 1 of 1
ONE CIVIC SQUARE BENTAX OF NORTH AMERICA, INC CHECK AMOUNT: $2,140.19
,z CARMEL, INDIANA 46032 34 DUNKARD CHURCH ROAD
y raH o RINGLES NJ 06551 CHECK NUMBER: 173732
CHECK DATE: 6/24/2009
DEPAR AC COUN T PO N UMBE R IN VOICE NUMBER A MOUNT DESCRIPTION
651 5023990 S11718 570 2,140.19 BULBS
t
Voice: 908-237 -1603
Fax: 908 -237 -0333 Order 17$ Invoice
Invoice Number.
Remit to: -570
BENTAX OF NORTH AMERICA, INC. fr r�
34 DUNKARD CHURCH RD 1 of North America, lnc.
Invoice Date:
RINGOES, NJ 08551 Jun 9, 2009
USA Duplicate
Page:
1
Sold To: Ship to:
CARMEL WASTEWATER TREATMENT PLANT CARMEL WASTEWATER TREATMENT PLANT
9609 HAZEL DELL PARKWAY ATTN: JEFF COOPER
9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
Customer ID Customer PO Payment. Terms
28103 S11718 Net 30 Days
Representative Shipping Method Ship Date Due Date
UPS Ground 7/9/09
Quantity Item Description Backorder Qty Unit Price Extension
5.00 1617.0009 BTXNA TUBE F 424.00 2,120.00
1.00 1620 -0005 BENTAXNA 30TUBE MAINTENANCE KIT
Check No: Subtotal 2,120 -00
Retums to: Sales Tax
BENTAX OF NORTH AMERICA INC. Freight 20.19
34 DUNKARD CHURCH RD Total Invoice Amount 2, 140.19
RINGOES, NJ 08551 Total Paid on Invoice
Balance Outstanding 2,140.19
E.I.N. 22- 3481265 [WFORM.001X4
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
357536
BENTAX USA Purchase Order No.
418 Meadow Street Terms
Fairfield, CT 06824 Due Date 6/15/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/15/2009 570 $2,140.19
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 1 5- 11- 10 -1.6
Date Officer
VOUCHER 095811 WARRANT ALLOWED
377536 IN SUM OF
B,ENTAX USA
4=1=8 e 3 `f �u� k C'h4Pc� rZd
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
570 01- 7202 -06 $2,120.00
570 01- 7202 -06 $20.19
O
Voucher Total $2,140.19
Cost distribution ledger classification if
claim paid under vehicle highway fund