177283 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 174625 Page 1 of 1
ONE CIVIC SQUARE KIRBY RISK SUPPLY CO
0 CHECK AMOUNT: $526.06
CARMEL, INDIANA 46032 Po aox 7700 -4117
INDIANAPOLIS IN 46277 -4117 CHECK NUMBER: 177283
CHECK DATE: 9/15/2009
DEP ACCOUN PO NUMBE INVOICE N UMBER AMOU DESCRIPTI
651 5023990 5104564070 173.60 OTHER EXPENSES
651 5023990 S104643795 101.10 OTHER EXPENSES
651 5023990 5104645396 244.46 OTHER EXPENSES
651 5023990 S104647094 6.68 OTHER EXPENSES
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
NUMBERI CUSTOMER CUSTOMER
NUMBER RELEASE NUMBER
74918 JEFF COOPER
SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHO
MARK S BAYS PK PICK -UP JEFF COOPER FISHERS 317 598 -6170 09!01!09
ORD D ESCRIPTION
lea lea ADVA 71A6552001 101.10 1 ea 101.10
MH BAL 100OW M47 5 -TAP KIT
lea lea PHIL MH1000 /U 6PK 30.88 1 e 30.88 0.62
298265 MH1000 /1-1 6PK
298265
Billing Questions: Billing (765) 446 -3054 NU20092.19:08 FM S104643795.001 Invoice Number S104643795.001
Subtotal 131.98
If paid by 10110/09 you may deduct $0.62 S&H Charges 0.00
Invoice is due by 10/31/09 net of any cash discount. Sales Tax 0.00
JEFF COQ PER 131.98
0001:0002 Kirby Risk Page 1 of 1
TERNIS AND CONDFLIONS OF KWE
ACATPFANCE (IF THF CARIDS PURCHASPA)ON'HIJS I Nk"010E(APISTIRAW WN D
ACATPMkNCE(K:�IIEl"t AND CONDHIONS (He SAIEWMA POLALONV!
k' j Noii-Sf.ock.Alvrchankse ig iwL um W& totes, we tau secure a "Rhmmd Go As !xAmm" twa
VIC wn&r'
f 3) f "e j'.; 'o i-"! e :ac lo iO ;L, S J lkl a 3i!.1 a 11 p I'l 1 goo k i S a A S a W V 20 q 110 n 1 S:10!,, A I I
iv".s oo '~Xl j OSS or iniplied '%vartalif ie� o f ""iel chaj�I'&ifity .oyd fig .1'e"' i'o! "I.,y" pal ti�LO.�nr
Culom. a-go-'es "_�]'at S ilor U no he A& 1w mg conuMm.o iCtt aoi!d lt 1L i.. Ind_ C�.TllcEges al
f W V aT 0.0 purcLa: rd by n SAW
kq onto a k"f go Q� Tway womi
�.'d upyin iz "41i I t I "rnv it K 1 be M11"! to th,w Tn ("C cr a
gyms n'
OnAmNe Selz IV it SUO! tax or 1WOMP selor YAM amynho MX OWWPAM e MOM,""
16) May in DAVery A! "I is a(A to he OXN.Whk jor'!"'J'1�;4 ir A Own okwyor
wor unumnyamms Owr Ohich SUN, I'm TM dun "PWA. INMWN QQOUM in doNny Wn am kk.�
No OnlHow OF(Wr MqTRY, anti in 11W Cam ShA Al he INK! iir all, c pix,,,�C
1'rim� �Iny J"Alla�'r�
(71 SNAver -Alia Wov, W upon"!'hc ofth_ �oIt%r"
i ?TJ
'Jil" 0" c2-..'j CA dr; ilghl lwlvundle k"ffl' nol, h.W deerned 'i
markow or npir in Ae hum:, aor it, (LcnA W be a Wwr o.� i eryy.'_ 'ondil�om ut
righ� undc:r Oi`,s
(N) Nlod!Hcadon of Terms and CvmTdm"—hW imus and candIons We; Ain I= mW bwAry, sno
Ila a"res nent or Wa SM Ind Wig, a;ly C, "WPI
on �'J�et kvid Qi.insent'
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
74918 PRIMARY LIGHT
SALESPERSON SHIPVIA
MARK S BAYS WC51 WILL -CALL JOE FAUCET FISHERS 317 598 -6170 09/02/09
lea lea PHIL MH10001UfBT37 6PK 37.76 lea 37.76 0.76
321505 MH1000 /U /BT37 6PK
321505
Billing Questions: Billing_request kirbyrisk.com (765) 446 3054 S 101200910:44bAN1 s104647094.001 Invoice Number S104647094.001
Subtotal 37.76
If paid by 10/10/09 you may deduct $0.76 S &H Charges 0.00
Invoice is due by 10131/09 net of any cash discount. ir'q Sales Tax 0.00
'c /FauCET 0 37.76
0001:0002 Kirby Risk Page 1 of 1
AND CONDIIIONS Ofi SALI
ACIAPTANCT Of THE OHMS PURCHASEB ON H S RIMCE CAIN S1 M F A
WTV VANCE (PP .V III, I URMS ANI) U)NDITUMS Mi SALE "WKY MUM:
AM Nypaan;'Ii�s 10 a o goods may he rtiu �od a "A"Op vozl'
z.;nd 1';--:
Tku-Slack Aferchrint%e is not Ychntskic Moss no can
Cie voyhy,
(3) fly c1invin amzo
PNV Inman sannwe� to inTiod Warlmhoo" �'m'd 'IGUI:.Nn
(4) Aw Cbswmer iTreng Wx 010 .t' €J ;io! ['e AV MW incd'eni'O
(5) =N focus Nwan tk not incluir yves o npo j on lh A, c nov (�r
WI VS Ncy i ppino 'ir J pmwe Ni P 1 bc w kin! o 1ho;wxhasc rdwc. Myn',yroesm
M! W MN oqyowh RAM 006 anq"bo Mx VWnTNW rVii5caw,
f6) 0"Aay ie 0 tivpry ;kt py is wl to h: awom,whic Q Ways 19 dca"n y novowms! by son of 0w o,
mn V±pnpzn""'q 'I NY MCI RAW 1TS 10) dina 'Opme. rM.7v Avows iWATIM, &am am vr'
he, Mmown Ova, SyThm am! ri my C.0 ShAl Soot be lhhlb
(it NyMer 71% Mna UPSAW 0) inns, ipm 1hQ perMumme of a, Jup WnM 01 andwWS 06"
C.Mad Ono "acks Mv r"N Nnomda SAN an R !0 b u. ("I
h" no A, abc Munt to he n vao or n y o6z; aw. PoWn; oi
(8) 0: f erms Arid cUdWoug Din termy and vsKiMs a W 0 mu aws, xtaQ Aunt and
in &1Y way
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
74918 JEFF COOPER
MARK S BAYS PK PICK -UP JEFF COOPER FISHERS 317 598 -6170 09/03/09
-lea -lea PHIL MH1000 /U 6PK 30.88 lea -30.88
298265 MH1000 /U 6PK
298265
Original Sale S104643795.001
Billing Questions: Billing request @kirbyrisk.com (765) 446 -3054 9131200910:39:44ANI S104 643795.002 Invoice Number S104643795.002
Subtotal -30.88
S &H Charges 0.00
9 :i Sales Tax 0.00
JEFFOOPER JOE B 30.88
0002.0002 Kirby Risk Page 1 of 1
E FU AND CONDITHINS Ch" SALE
ACCEP CA NCEM THE WHODS PURCHASED ON1.131S IN"'(1WE WNSTWITS AND
ACCEPUANCEOP M I �e()I. I. O'"t.
is vuhmm"ble 16cow E. a a lion,
(31 7% MEW nano Own Wyes an! agnes thnin as purchawn argoodnK anus Wn Soon MO.
V( t'N'j)IeSS kw Ophed Own F, OOqvMWQi
(4) h': =pys W Seto %Q no be hdkn ro: £my
G) Wn Wo Nhown w: Wu• valo, av Wer tann wqvxvd-,;
1yon MO M Oymccn J i'o "he
rdulmxv Soon RV W! Nwh tax or povido S&V w4h un!"b[c MX OWIVKO caskyn.
15) Deby:n Ikkay Evn it m; to he yam-WO 0, Man to Waxy onnshmed by aw of i VW-,;
(M her whidi SO W has no 0 Von croon! Rummy "'11'm ..:1 (vJjKxyWN an .:3:;
how zwksten 01 of .110! it In Can NUB RM be Uhl RW mh .:wp a;WUH (a qyml
OV 610 humadw ME no be MW 10 ho a n tin: or not WrA"
w Tc k.£= nnali n hu ownd to bc a Y&Tr ciao, Mor wry mWOun, or
111�2 !-i E J'- ihis
:81 skodkown of Wns and COMMT- to Wnus and COANWIS My man 'Wod
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER NUMBER RELEASE NUMBER
74918 GFCI BREAKER
SALESPERSON SHIP VIA ORDER ED BY SALES OFFICE PHONE NUMBER SHIP DA TE
MARK S BAYS WC51 WILL -CALL JOE FAUCETT FISHERS 317- 598 -6170 08/26/09
ORDERCITYJ SHIPCITY I DESCRIPTION' ITEM PRICE UNIT EXT AM I OUNT CASH DISC
lea lea AB 1492- AMCDINI 4.24 lea 4.24
DIN Rail Mounting Adapter for GFCI
and GFEP devices
GFEP devices
*SUBJECT TO VENDOR RETURN POLICY`*
Billing Questions: Billing (765) 446 -3054 &270200910:38:25AM 104%4070.002 Invoice Number S104584070.002
Subtotal 4.24
f SOH Charges 0.00
Invoice is due by 09130109. G Sales Taxi 0.00
JOE AUCETT 4.24
9002:00112 Korby Risk Page 1 of 1
rmwo V41) CONDITIONS OF SALI.
AUTPIKANCK OF 4111 (AJODS VUR'4',AlASEl) ONTHIS IN VOICE' CONSlill-11-S AiND
ACCEPTANCE (A THUITIANIS AND =02 10,NS OFSAVE M H'�Cll RNAA
"Renawd UWAS AM&Q" Non-,
n&r'
(3) The olugune nksmUps mO opwa On in K pwcha ofgoo&
,Wes no wNISS waamwe" (g WPM younuos !"!Iy palO:u it
PRUPOSO,
1 1w cusizimer vers ubw sewn� ��c
Awr aw Cniso asyx�ocd woo rho pXV& PuNhawd f4wo SO&
1 wes lwwu'i ]ot incw(w ;,us 0V (the Lives ippwad 0!1
wwaNcr hnqwd tT on 0 0"ht"aw, WM be „will to the panhasc [Pico f3uppaglyew
00ay ir Dcli� cry or K mm to in dwwnwbk koi d; ia -s iii duii wd by act "'Jod ol
w5w A(.'uw�N%vs owr QU Schct Ins in) dmw covok Famwy QmAw ty dW%) WIn my
kv Q00aws OfNa S"porn ml hl rc; cam MAI Sohn Q hi&;', br
F-on. d lw 1n
NViver lho a, WK up(m the pwUnnanx J!qAAw ww"T nmd5wA o0h1s
t;,_ Iij v aux Aght 1wrounder 61wh no he demwA 0) be it ouiver or such wims,
s'ondi( :.ons ih'� h�' ok�Qnlvd to he a YnOr 014% 0awr Ono. cawwwU% 0'
rqw unwr ymow,
a 8) Nlildlfjcaflkm of Terms and C➢dWons DO Unng and coWbAns ullwyAnq %se MY ITAT M�
ro ngnuums rl nodesmawal to any "ay PUM001 to ox�dit�' o'. bv
cil"
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER PON UMBER RELEASE NUMBER
74918 GFCI BREAKER
SALESPERSON SHIP VIA ORDERED OFFICE PHONE NUMBER SHIP
MARK S BAYS WC51 WILL -CALL JOE FAUCETT FISHERS 317- 598 -6170 08/01/09
ORDERCITY1 SHIPCITY I DESCRIPTION ITEM PRICE UNIT EXT AMOUNT CASH DISC
lea 1 ea AB 1492-MC 20 169.36 lea 169.36
GFCI Device, 1 inch wide, 10 kA
AIC, 1 pole, 20 Amp
*SUBJECT TO VENDOR RETURN POLICY
Billing Questions: Billing_request @kirbyrisk.com (765) 446 -3054 81270200910:36:38AM 6104584070.001 Invoice Number S104584070.001
Subtotal 169.36
S&H Charges 0.00
Invoice is due by 09/30/09. Sales Tax 0.00
1017 IF UCETT 169.36
000,:000z Kirby Risk Page 1 of 1
rums xxi)
ACCEPTANCE W THE (AWDS PURCHASED 051 TV IIIS
ACTFIPTANA I 0F THE FERVIS VNDf]0NDv'M)NS
No goods any be unumW KIM o WMAn KW
md pnio.
�Mvlvhamuse is nva 101unnise Moss TVQ cao SCOUR: a 711eoil Dc",
Ole Yank"
10 Comwavy ackinwedps jud open Ihs E aF purch�,�t�.. firo:.n
cg hyHed and Ltd nss Rr ony pookuhu
(4) 1 ne Slim xT not W Doe or any zwoeywol nis Mciew dawyes WQ
purJ:,.i-4ed lfrol� 'Sfci;,�I
:51 1 �vuy nowa do Wi inn ludc sales or (4 key unn hyx Wn I Pw no c4pyw in ON ,z iii
sLipnony WA we Mod tothz run q.
rMaNe Rely QW W" WWh VIX OY jmvvioe Sell. "Ah MWWWok WX CWwrky .a, 3`-'L=.
16) Dahty in Dehyry 401cr is nut to :7, ownwYnNe INAMv K Wbus occnkuwd bY aOs 0 of
cowl ovcov, hAs YNI V1141 comad. MW y Y �Lltes. Ix
o! sopplkr 30 in no can nhaH Scher b,, habio 1'(.a ('r ocin!
(7) Water --Ill 0 Wnk V:. i ti,o
c� ,'X, Wxv Mv win haeunder MY not Inc dmnTd to bo n YK"r of gwh !an
noub inn ur 6p to the Wtus-C, nor it 1.--e J, cmvd to be a va nyr o!hc t, nrn, C:and inon, oi
YjW ovor TA QMM"n
3WHWaW of Terms and C>Whns No (Cans and cakkkonq Wei Man amp, vand Inrein, an!
no apennex ry undusmuUnn in any puvpo vng 'un-,odi�v of J"al".
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER NUMBER CUSTOMER PO N MBE R RELEASE NUMBER
74918 PRIMARY GALLY
SALESPERS ORDERED OFFICE PHONE D ATE
MARK S BAYS PK PICK -UP =FF COOPER FISHERS 317 -598 -6170 09/01/09
ORDER OTY SHIP QTY DESCRIPTION ITEM PRICE UNIT EXT AMOUNT CASH DISC
4ea 4ea LITH 2GT8 4 32 Al2 MVOLT 114 61.12 lea 244.48 2.44
GEB101S PWS1836 LP735
Billing Questions: Billing request @kirbyrisk.com (765) 446 3054 901020092:21:18PM 510464539 &001 Invoice Number 5104645396 001
Subtotal 244.48
If paid by 10/10/09 you may deduct $2.44 j_ 1 S&H Charges 0.00
Invoice is due by 10131109 net of any cash discount. Sales Tax 0.00
JEPF DOPER 244.48
0002:0002 Kirby Ri Page 1 of 1
'I'ERMS ANT.) CONDITHMS (Mw SALE
AWEPFANCEOII THIE, COODS PURCAJASE'DON THIS IMAM It MNSMUTTS AND
ACCEPTANCE OF THETERNISAND CXMIMONS M SMA MIMM FEMAIM
No own my h wocd vv,�Jlhow a
t2l MuStoel; Merchandise is aut inumable Men wo un scume a "Reluand Good. uMn g" non',
0) fin ondl ag-' fl"O! io 0 puWascs urywyk
m ��-q)ress ;a tes, or luldial an)
7tupose,
j4) 1 in t£,.f E "cx ,,.,;I not r"c fiobk Co f ilily nk RAW Mmys w. k:
i n%w- !Ws Man do "y Mum SUON Oz odor taws impacd on &V sale v? 0' 10 MCI wo w
bottom imp mud U non Ov wii Im iAdcd t(" 0"
1 any Nwh Mx orTmtile, War Wh arcupukk wx owilvion curnwate,
(6) Mq, in 1'' lloc �i:" zwcuurt"IWC� �E 'I in 6 uc?'; o!'God or
(ARY CACIMInnow O"r whwh Sucr WS in; dawcomn! MM or c�il�n� '��u
buq Wwans How suINOwn, mul in in cast shyll Sulorkx 15% Am Aw conscquenual or sluxin-I
(7) WAver --R.c o 'SQHcr t'c ul"e"', lie purknanuce of'mi% ol'Oto ni',bb;
t�r rigH hckeundev sivP nm Ix Wnwd to be as vain- Wnh wim,
con ai' 3 in dy fia"M ny"haH a he dwnwd w be 3 MuNn onm! moo on, cowbwn,o�
I"
ui'idcc Om�� ccnirw,
18, MoMeation of Orms and (A,== TO k2rin�ti nd th'm' �'Iawd j"'1.6n <i:)d
no apoctuaw 0" Uadesmusn" Lij x"I stn y patporiog 10 nods, West terns. or c(MOAM. SHE b".
hiv&ng ��irj.n-en �';A"S"'IJ'
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
174625
KIRBY RISK SUPPLY CO Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 9/812009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/8/2009 S104645396. $244.48
`1
�i
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 IL
Date cer
VOUCHER 496369 \MARR-ANT ALLOWED
174625 IN SUM OF
KIRBY RISK SUPPLY CO
PO BOX 664117
INDIANAPOLIS, IN 46266
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
S104645396.c 01- 7202 -06 $244.48
5IUL15840 D1.7252.oG 161.36-
SIf7'�58`1D OI_JZao•o� N•2�
SIC�4b`t3�45.bo� �ao.88�•
srt�u(n�,'3� g5.op1 of.�2b3.Ot 131.9f�
Voucher Total $2
Cost distribution ledger classification if
claim paid under vehicle highway fund