177222 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 355550 Page 1 of 1
0 ONE CIVIC SQUARE H S B C BUSINESS SOLUTIONS CHECK AMOUNT: $187.58
CARMEL, INDIANA 46032 PO BOX 5219
CAROL STREAM IL 60197 -5219 CHECK NUMBER: 177222
CHECK DATE: 9/15/2009
DEPARTME A CCO UNT PO NUMBER INVO NUMBE AMOUNT DESCRIPTI
651 5023990 20455409 187.58 OTHER EXPENSES
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ACCOUNT: 7003 7059- 2105 -2987 PAGE: 1 OF 1
NORTHERN TOOL EQUIPMENT PURCHASE DATE: 08/24/2009
INVOICE: 20455409 SHIP TO: CITY OF CARMEL
9609 HAZEL DELL PKWY
P.O. S11825 1Z2129750341234612
AUTHORIZED BUYER: 0000000000009915239 INDIANAPOLIS IN 46280 -2935
IrEM! t5E8Ct2[ gUAN ITY u�+tt PRICE' ISCOUNT rural.
11781 FORK LIFT SEAT UNI 1 $169.99 $.00 $169.99
SUBTOTAL $169.99
TAX $.00
SHIPPING /DELIVERY $17.59
TOTAL INVOICE $187.58
A-1.5%-LATE-CHARGE WILL BE ADDED MONTHLY TO ALL- BALANCES JNPAID:
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This communication serves as official notice that all calls to /from our offices may be monitored and /or recorded for quality
assurance purposes.
o Tired of working in a hot shop, garage or barn? Check out Northern Tool s large assortment of fans and cooling units. We have something
to fit every cooling need.
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Important Notice: Promptly review this statement and notify HSBC Business Solutions in writing of any errors or
unauthorized purchases. If you do not notify HSBC Business Solutions within 60 days of errors or unauthorized purchases,
this statement will be presumed to be correct.
Write to HSBC Business Solutions at P.O. Box 4160, Carol Stream, IL 60197 -4160.
You may telephone HSBC Business Solutions at 1- 800 210 -8115, but it will not preserve your rights.
Notify HSBC Business Solutions in writing of the cancellation of a credit card or authorized user.
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
351578
NORTHERN TOOL EQUIPMENT Purchase Order No.
PO BOX 1219 Terms
BORNSVILLE, MN 55337 -0499 Due Date 9/8/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/8/2009 20455409 $187.58
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
v (q o 5
Date Officer
VOUCHER 096364 ,WARRANT ALLOWED
351578 f/sr IN SUM OF
R►4RTHER-N�00L EQU°I- PME --W
SZ19
BQ -+4 VIL= L -E-MN= 5 55337= 99
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
20455409 01- 7502 -06 $187.58
J�
Voucher Total $187.58
Cost distribution ledger classification if
claim paid under vehicle highway fund