176823 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 00351017 Page 1 of 1
ONE CIVIC SQUARE KIRBY RISK ELECTRICAL SUPPLY
i 0 CARMEL, INDIANA 46032 PO BOX 664117 CHECK AMOUNT: $1,190.22
INDIANAPOLIS IN 46266 CHECK NUMBER: 176823
CHECK DATE: 9/2/2009
DEPARTM ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESC
601 5023990 W08915 5104582340 427.79 MONITOR
601 5023990 W08866 S104586076 728.12 MOTOR DISCONNECT
601 5023990 S104623763 34.31 OTHER EXPENSES
t
"r DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
i dUSTOMER NUMBER RELEASE NUMBER
11788 WELL 7 TOLAN
SALESPERS
KEVIN R FORD DIRECT NO FEE BRIAN TOLAN INDIANAPOLIS 1 317- 687 -0015 08118!09
,ORDE
3ea 3ea ATC SLA0290 140.56 lea 4217
ATC PHASE LOSS RELAY
KRPNM
SUBJECT TO VENDOR RETURN POLICY"
4 WEEK LEAD FROM THE FACTORY
qf� P,
W�
Billing Questions: Billing_request@kirbyrisk.com (765) 446 -3054 Invoice Number S104582340.001
Subtotal 421.68
S&H Charges 6.11
Invoice is due by 09117109. Sales Tax 0^4
0001:0001 Kirby Risk r
TERAIS AND COMIFFIONS OF N"I"ItILE
AC(APTANCE OF: THL'(A)ODS FUR(.'HA,SE`D ON I HIS INVOIC CONSI 2 1 U FES AND
ACCEPTANCE OPOHE f ERNIS 1,M) ONS OV SM;E'�kRICII I'OLLO'W.
11) Stock Merehalmis, in nn"" ht
V2) Wo Moth Wereh a Mse it not mmlj& i cc Is s it? vAn jUlUtV "R'mi I f:
We
(3) lbo "no ied"Ces J�."! It -'a i ll al"I, ")MUnns of g=6 and S.. M. My sown sdk',.
x inphcd "Ind iCr
(4) 1m C vwcr.�' qpe"�' �'eJ"'r -xi.jl noL i'E7 1� foj� 'Ird mc Wnd Mons TOKI
v'iTm fk4� !"ood:� rv��a:�ed frorr
Own do W, vChAt m&s w p0w; Lacs P iWond on &c 4 an4 Oqw Wmi an
n" 'o'.- �jvr aW O"hMmann WK! be WAIM �o th:� ag!
(01 p"6 t WX Orgovidn SCA"r [h
16) Way W Wveq ....Am y K lo be mannubiv ArWays 1 iMmy onm6mcd by am MOd c'
5 On cmvlpmpu�w ON"r Whin, SO W has no duva VOOK Won who (W Jova 1 Ann AV m
KLY um tai Und: AqTAM,:uNf A id, me A&I SAW no hia�"Ic i'ol
(7) NY% lver 11W Goon W ScHet Do WRI UFC 1 ;fic peAlmroa'cIL'i. tO'any
1"onp"ac1. or 1' ..l !'i�7n sp NJ Inroundu WH no he to bun,
mmmom or Kghi in Ihe can: MW imp ina amnwd W b
(81 AdodMalm of Tenus and (NuMus Ro unns MW mylo.'n-, G Ih" .vm' ",wed jl
w any mmy puToning thiese k lls' 0.",
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
C�STOM I ER CUSTOMER PO NUMBER RELEASE NUMBER
11788 PLANT 5
SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE
MARK S BAYS PK PICK -UP BRIAN TOLAN FISHERS 317- 598 -6170 08!19109
ORDERQTY SHIPOTY DESCRIPTION ITEM PRICE UNIT EXT AMO D ISC
lea lea CULL 37011 34.31 1 ea 34.31
16 -in -1 TAMPERPROOF SCREWDRIVE
Biding Questions: Billing_request @kirbyrisk.com (765) 446 -3054 arls+2a0s1:5asoPnn S104623763.001 Invoice Number 5104623763.001
S u btota 1 34.31
S &H Charges 0.00
Invoice is due by 09118109. Sales Taxi 0.00
s
BRIAN TOLAN 34.31
0001:0001 A Kilroy Risk Page 1 of 1
TE AND C',0NDMONS OF SALE
AMEFFANCE OF THE (AXIDS PURCHASED ON I U 11,S �,ND
ACCEPTANCE CMDU IONS TAT SAIF WIMS MUSM:
Nou-*i',ock 4'ie1TWn(HSv is a. `.W ,M..1.: MIKA VA CM SMAM
(5) BY in au pwchmes orgo.N ano swYkaw On; 440 WHO:
141 Tile f H. ',�x st"jjQr h L J-k J�.v <,Iuj Ww"M dro;Egg wish"
L,ill; the p)M ftoln Sc:lo',
ww"n "I "A nvww 0, a 010 NON RIAMA on QQ SAM "MWA Yncs "W=
PROW Vyvnd 1MM SAO orstawpw wy be M'd k-,
i6t w? iioh tax ovide Se1wr x5h wompubhe nA ewnTtm cat
(6) Dcksv 9i7 Sa Ikr K wM to be vicawnwAn fm Mys 1 dchverl occammiS jq nos MAO
why MR._- 0% Us Tal dhow cOMR, Fwwwy shipum or delhoi I Mes sic th,
VVI: 107maws 0i mg ngpo"n so in ro Gan shol W!"r t w hahh iibr 2011.-
r') Wiver !he 111 [0 0 f Sd r 1,t; lsi t upon, "w nk"i: o F n[ e1€ itions it. i,'1,
ao to iekwe my i IN han undu ;hN not Awnwd to be a aw m; o r w. h ems,
r UOM on umax-1,
(W 1tWULMH Gf Terms an d Condh%s No wrnls a, ,awn flb�os sm!, J
so n,yerew m undavwAha Ln &q vny pwpxtW nw'V�! tnd�
c Wors Knou episcol,
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER NUMBER CUSTOMER PO NUMBER RELEASE NUMBER
11788 W08866
O R D ERED SALESPERSON SHIP VIA
KENNETH R WALTERS PAR PARCEL DLVY KEN RHODES INDIANAPOLIS 317 687 -0015 08 ISM
ORDE R QTY SHIP QTY DESCRIPTI ON ITEM PRICE UNIT EXT AMOUNT CASH DISC
2 e tea SIEM HA361234 79.52 lea 159.04
30 -200A AUX CONTACT KIT PLC TYPE
SUBJECT TO VENDOR RETURN POLICY
lea lea SIEM HNF361S 569.08 lea 569.08
30A- 3P- 3W -600V TYPE 4X HD VBII
NON -FUSE
Billing Questions: Billing_request @kirbyrisk.com (765) 446 -3054 Invoice Number S104586076.001
Subtotal 728.12
S &H Charges 0.00
Invoice is due by 09105109. Sales Taxi 0.00
2 728.12
0001:0001 Kirby Fisk Page 1 of 1
TERMS,AND C0�NW11ON'.'.'i 0. SAIA".
WAPTANCE (IF THE (AWDS PURCHASED ON W IS D
ACWTPWANCE 01"THWITUIS ANU) WNDUVENS UMT SKLY W101501 FOLL0%
131 NAWlack Nee handkt n wX MMUNU uAms W, am swum a 150 ned GO;& ?,aAhWQ" lual.
00 N e OW,
13) W mWonodys nj .:Jr, a. dn; in at! pumases of,ody aind savle Anni Ask,, Sdbr
jaKed Yon"On Qr
(4) 11W C �e hjbiF' 1'N any
Amn V"Y came fl-e t'�ood4 firolr sc!kx'
(5) Wes Wn Awwn 1 my WE- mls x odn Ova inqwwd on N nk A pwd" Tun; wo or
iqmr YA, umh I mono W i bc Wal its to pnYhow 1p We Rdynigco0o
Ft- rvnr such ax or Wor wim vvyUk an awnTlAm
(6) Why in Iblotcy— UOT in Y;A io bc annumalde W W hi dKinTy ovsAward b oan Whdar
")Vcr "vhich S�� n Ills T") dow Untrv. P.VY; Atnom CW Win Kn 31C w'-
f a "Hu StWWW" and K on cam ShA 1)"
f 7; 0% liver 1 in a MAC 1K Sever 1C 00 so nprm t hi: perfio of oy ,y` [i. I enn"
c ?i i 0 "Xcl a hummW s W R a 0 hu henwd to he a m I my of sw h a �'ms,
.1 1_ ""S 0�` in A WMA VW shyj 4 R (Renwd W he n nova apmy 0TU UnAoWu0n, ol
UOU: to,
(N) VdmUfQdKn of Terms "nd Va !llfltjons —.No tun and t mWns Wn rhan Won sunj (.t :e
Prescribed by State Board of Accounts City f=orm No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must shovel, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351017
KIRBY RISK ELECTRICAL SUPPLY Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 8/26/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/26/2009 S104586076 $728.12
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
VOUCHER 092816 WA,RRANT ALLOWED
351017 IN SUM OF
K-RBY RISK ELECTRICAL SUPPP�I,
PO BOX 664117
INDIANAPOLIS, IN 46266
OA �L!
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
S104586076 01- 6200 -04 $728.12
5 idq ��3`7i�3 cl•�•GtE 3+-H�
T gl 5 St�i 34o 1 0-�M- CZ- W- t
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund