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176765 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 117785 Page 1 of 1 ONE CIVIC SQUARE HP PRODUCTS CHECK AMOUNT: $56.25 CARMEL, INDIANA 46032 4220 SAGUARO TR PO BOX 68310 CHECK NUMBER: 176765 INDIANAPOLIS IN 46268 -4819 CHECK DATE: 9/2/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP �a1120� 4238900 y I0556819 56.25 OTHER MAINT SUPPLIES Women-owned Business Enterprise (WB£) x.: Excellence in Distribution HP Products CORPORATE OFFICE ISO 9001:2008 'fyV ®1`i� 4220 Saguaro Trail Indianapolis, IN 46268 Certificate Number 2006 -005 Phone: 317-298-9950 FAX: 317 293 -0459 Dale 8/17/2009 Ship To 1 000072 CITY OF CARMEL FIRE DEPT Sold To #:CO21876 2 CIVIC SO CITY OF CARMEL FIRE DEPT CARMEL, IN 46032 2 CARMEL CIVIC SQ CARMEL IN 46032 F No. I Invoice Date Terms Customer Purchase Order No. Sales Representative !0556819 81 C9 Nit' Gary �0 Gary Carter Rajah ohaviirani (Vivi 1671 Order No. Order Date Ship Via Customer Reference Customer Service Contact S00629616 8/1012009 WILLCALL Extension 1300 Notes Special Instructions Ordered B/O Shi UOM Item No. Descri MFG Item# Unit Price Amount 1.00 1.00 CS 115250 GOJO 5163 Luxury 5163 -03 56.25000 56.25 Foam Hair /Body Wash 1250ml 3 /cs 4.00 4.00 EA 115252 GOJO 5150 FMX 12 5150 -06 0.00000 0.00 Dispenser Gray 6 /cs Subtotal: 56.25 Sales tax: 0.00 Invoice total: 56.25 Amount paid: 0.00 Total due: 56.25 Remit to and make checks payable to :HP Products 4220 Saguaro Trail P.O. Box 68310 Indianapolis, IN 46268 -4819 Page 1 THANK YOU FOR YOUR BUSINESS! 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)) 10556819 $56.25 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 HP Products t IN SUM OF P.O. Box 68310 Indianapolis, IN 46268 $56.25 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 10556819 42- 389.00 $56.25 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 AUG 31 2nn Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund