206178 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 00352813 Page 1 of 1
ONE CIVIC SQUARE CENTRAL INDIANA HARDWARE
a CARMEL, INDIANA 46032 P.O. B OX 83030 CHECK AMOUNT: $2,746.38
+'r CHICAGO IL 60691 -3010 CHECK NUMBER: 206178
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 R4238900 27351 0078827 -IN 2,746.38 ROLL TOWEL DISPENSERS
C I H INV ®ICE Paee I of I
Central Indiana Hardware Schricker Division
since 1951 P.O. Box 83030, Chicago, IL 60691 -3010
Schricker Division 800 -218 -8866 317 -578 -1984 FAX Invoice Number: 0078827 -IN
Invoice Date: 1/27/2012
Order Number: 0138115
2 I Order Date 12/15/2011
J Salesperson: GWD
J t Customer Number 51- 0003247
Sold To: Ship To:
CITY OF CARMEL CITY OF CARMEL
I CIVIC SQUARE 1 CIVIC SQUARE
CARMEL, IN 46032 ATTN: JEFF BARNES
CARMEL, IN 46032
CONFIRM TO:
Customer P.O. Ship VIA F.O.B. Terms
27351 Net 30
Item Number Unit Ordered Shipped Back Ordered Unit Price Extension
Item Description Color
*3961 EACH 6.000 6.000 0.000 457.73 2,746.38
ROLL TOWEL WASTE RECEPTACLE
D Q
FEB 13 2012
By
NEW REMITTANCE ADDRESS
CENTRAL INDIANA IIARDWARE
P.O. BOX 83030
CHICAGO, IL 60691 -3010
Remit Payment to: P.O. Box 83030 Net Invoice: 2,746.38 Less Discount: 0.00
Chicago, IL 60691 -3010
Freieht: 0.00
Sales Tax: 0.00
Invoice Total: 2,746.38
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))
01/27/12 0078827 -IN $2,746.38
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 NO.
ALLOWED 20
Central Indiana Hardware
IN SUM OF
P.O. Box 83030
Chicago, IL 60691 -3010
$2,746.38
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
27351 0078827 -IN 42- 389.00 $2,746.38 I 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
Monday, February 13, 2012
Director, Ad
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund