206258 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 358710 Page 1 of 1
ONE CIVIC SQUARE H D SUPPLY WATERWORKS LTD CHECK AMOUNT: $2,242.00
CARMEL, INDIANA 46032 P0 BOX 91036
CHICAGO IL 60693 CHECK NUMBER: 206258
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
604 5023990 4293104 2,242.00 334I.40
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You.
We appreciate your prompt payment.
Date Ordered Date Shipped Customer PO No. Job Name Job No. Bill of Lading N Shipped Via Order Number
1117112 1 1123/12 W09621 I EXPANSION CON OUR TRUCK 4293104
Product Code Description Quantity Quantity Back- Price Per Amount
Ordered Shipped Ordered
3910EC4 EC -4 1 EXPANSION CONNECTION 100 100 22.42000 EA 2,242.00
This transaction is governed by and subject to HD Supply Waterworks standard terms Terms SubTOtal
and conditions, which are incorporated herein by this reference and accepted.
To review these terms and conditions, please point your web browser to
http:/ Iwaterworks.hdsupply.com/TandC]. NET 30 2,242.00
Frei ht Delivery Handlinci Restock Misc. Tax
$2,242.00
HDSWW INDIANAPOLIS IN -W THANK YOU FOR YOUR ORDER 4293104
Branch 430 VISIT
1680 Expo Lane WATERWORKS. HDSU P PLY.0 OM
Indianapolis IN 46214 FOR OTHER SERVICES OFFERED Page 1 of 1
0001:0001
VOUCHER 113714 WARRANT ALLOWED
350591 IN SUM OF
HD SUPPLY WATERWORKS
PO BOX 91036 WATER CHICAGO, IL 60693 -1036 �PE�n�NS
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
4293104 02- 2308 -00 $2,242.00
Depreciation
Voucher Total $2,242.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
350591
HD SUPPLY WATERWORKS Purchase Order No.
PO BOX 91036 Terms
CHICAGO, IL 60693 -1036 Due Date 2/8/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/8/2012 4293104 $2,242.00
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
Date Officer