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176540 08/20/2009 CITY OF CARMEL, INDIANA VENDOR: 00350752 Page 1 of 1 ONE CIVIC SQUARE HOLT EQUIPMENT COMPANY, LLC CARMEL, INDIANA 46032 3673 RELIABLE PARKWAY CHECK AMOUNT: $44.30 CHICAGO IL 60686 -0036 CHECK NUMBER: 176540 CHECK DATE: 8/20/2009 DEPA ACCOUNT PO NUM INVO NUMBER AMOUNT DE SCRIPT ION 601 5023990 1349311 44.30 OTHER EXPENSES *LT EQ. NPMENT COMPANY LLC Parts I 1 1 VO I chi 3673 RELIABLE PARKWAY CHICAGO, IL 60686 -0036 Phone: (502) 254-0758 JOHN DEERE S CARMEL WATER DEPARTMENT PAGE H CARMEL WATER DEPARTMENT L 3450 W 131ST ST 1 1 D CASH CHG.OTHER P WESTFIELD IN 46074 -8267 US T ACCT. NO T O O 501992 SALESMAN I ORDERNO. RO.NO. PHONE IN VOICE DATE TIME INVOICE NO. 112 38 0 0543461 317- 571 -2643 05AUG09 13:56 01 1349311 QUANTITIES I PRICES ORDERED SHIPPED B/O PART NUMBER DESCRIPTION BIN LIST NET EXTENSION MAKE: JD MODEL: SERNO: HRS: 1 N T155827 HOSE XY V23C2A 39.30 39.30 39.30 2 N TY22470 CLAMP V15K3 2.50 2.50 5.00 IT'S AN ALL NEW BREED OF DEERE! ASK A SALESMAN ABOUT THE NEW K- SERIES LQADERS. HOLT IS NOW AVAILABLE TO YOU 24 HOURS A DAYS 7 DAYS A WEEK! FOR FAST, EFFICIENT SERVICING OF ALL OUR PARIS SERVICE NEEDS, PLEASE CALL (800) 595 1081. I VISIT US ONLINE AT http: /www.holitequipm nt.net I n J DESCRIPTION ACCOUNT AMOUNT SHIP VIA W C PARTS T A X A B L E PARTS NONTAXBLF 44.30 MISC TAXABLE MISC NONTAXABL.. SALES TAX RECEIVED BY PLEASE PAY THIS TOTAL 44 30 -1137 CUSTOMER COPY 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 00350752 HOLT EQUIPMENT COMPANY LLC Purchase Order No. 3673 RELIABLE PARKWAY Terms CHICAGO, IL 60686 -0036 Due Date 8/11/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/11/2009 1349311 $44.30 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 0 Date Officer VGIUCHER 092593 WARRANT ALLOWED IN SUM OF OC•350752 HOLT EQUIPMENT COMPANY LJ 3673 RELIABLE PARKWAY gyp' C IL 60686 -0036 z OAL eV' x' Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code i 1349311 01- 6500 -05 $44.30 f Voucher Total $44.30 C st distribution ledger classification if claim paid under vehicle highway fund