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177735 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 174625 Page 1 of 1 0 c.,yf ONE CIVIC SQUARE KIRBY RISK SUPPLY CO CARMEL, INDIANA 46032 PO BOX 664117 CHECK AMOUNT: $382.77 :yk,rc INDIANAPOLIS IN 46266 -4117 CHECK NUMBER: 177735 CHECK DATE: 9/29/2009 DEPAR AC COUNT PO NUMBER IN VOICE NUMBER AMOUNT DESC RIPTION 651 5023990 S104654959 12.87 OTHER EXPENSES 651 5023990 5104671646 175.80 OTHER EXPENSES 651 5023990 5104672760 194.10 OTHER EXPENSES DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT CUST OMER 74J18 Kingswood Larry t�4 SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE SALESPERSON lu ED ZINK WC29 WILL -CALL Joe Faucett INDIANAPOLIS 317- 687 -0015 09/17/09 ,ORDER C ITY SHIP C DESCRIPTION ITEM PRICE UNIT EXT AMOUNT D ISC 10ea 10ea AB 700- HLT1U24 19.41 lea 194.10 700 -HL ELECTROMECHANICAL RELAY OUTPUT Billing Questions: Billing_request @kirbyrisk.com (765) 446 -3054 N18r2009 9:33:43AM 6104672760.001 Invoice Number 5104672760.001 Subtotal 194.10 S&H Charges 0.00 Invoice is due by 10131109. Sales Tax 0.00 Joe Faucet 194.10 0001:0001 Kirby Risk Page 1 of 1 CA)NDFIANYS OFSALE ACCAP FAK0 0VI f-ITS kW ACCIPTANCE OF AV) C0MW�10N Mt 0) Awlt MiJaWhW I WOUL to e luluo; chaygn Ski giNd"W" n �:Vl v NT 1 m n d i It i A Y 0 c rw to b! 0 1 it on C 3) T W Gvs�in c i'�j "?'V> WS and sy Was �J'! Lt 'C' of '?dk' '1 �J' is no uq4es Km runW, or i ophod wnrw A Q v u W"Aanlaw I Ky MY Wess fat any P 10 &Q jmTov" (4) 1 ;w Clalomer Rgivey that vi�l k)l "UC LDbIC Or Pa LYWOT%M.��al 'In'; xQM'W> camv 20,00nd Wdl Q& poor P"Am"d lv�' S. Mun Owwn du mq Unkuk Avvm Aw taws hqvml Y; ho wk jvW Twos wwA olmho Aqvvio qVY MIA a ?Qlum; 0 1 he ad0d Pi w�:"' ;my YWh wx 0: TWA WT m U-Ji"'Uvy vviv 14 1W, '0 W lw�'MrildhA A), Ways in dellony 0"W"KnIj V� nos of UK Or uhKT 40unsy"cc v,'L UAmr> silwas or Wwi mc Ac On A 0"W.NS i 7 SITAnC MWI in iv saw A. S i I V jh C "o ln"i7't upon. WHOM IMACAVW&e my 611 hunodn AMU WA be IlmnWd to A n 'Any 01 W lvaus, in be Down nx shl a Kc WiWv bc a inlvm of any oW vat conddn�, o' S) McaMcAun of Terms W CondhKas Rio tows and cowhHons Wei C un 0. a, wroW Amu, ax" no all"Unn Pr an"INMOGO in any way pumoi"'� nil ik. ilrimhj� DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT CUST CUSTOMER NUM13ER 74,918 JOE SALESPERS ORDERED BY DAVID L MOORE WC WILL -CALL JOE FISHERS 317- 598 -6170 09/08/09 ORDER QTY I SHIP lea lea LITH L2GT Al2 12.87 lea 12.87 0.13 LENS F12GT 440 L2GTAl2 Billing Questions: Billing_request @kirbyrisk.com (765) 446 -3054 91612009 2:17:35 PM 5704654959.001 Invoice Number S104654959.001 Subtotal 12.87 If paid by 10/10/09 you may deduct $0 -13 �Ct S&H Charges 0.00 Invoice is due by 10131/09 net of any cash discount. Sales Tax 0.00 r .12.87 JOE 0001:0001 Kirby Risk Page 1 of 1 1 T1 AND k.A)NDFURINS (AT ACCEPTANCF OF THE (AWDS VURCHASED ON ACCLPTANOY ANO CXINDIMONS OF TW: MIMI MMOVA 11) Mock Mouhnniuse is v)a nf"!ura Chypiv No goMm*40 Nuxwd whim a Oppul" Ww", irn �';Ct Inehoncuse is mt ra unnyle votes two am 1"ux a W OYAR 60 A N inwhanT M'. (3) !�W Q LN&MV ISM MOAdIt a Wd AgOSAVO in P poRkany of I x% o ad sea an q fm� SALY, MW yi ts no o ivxs whAnumv ov inthed wivanw, N EYmhYYAHq W�4 Wr my ImM W9 14) 1VOYmpoop on WRAWN YW he HAN WT my 151 To us do my WAMIC so �v OARM in X-M imp(Sud on r a O"Mytody Txo��x o Q! brMIM: o we pun p in" KS nly an ii) 0 U&MW MW 01 nov such tv 0' P10610 WOr Mh ncwmbw WX SM or sm CV6 W (0 141, in ISHvev; Sclir sm bc vmm cat nt Vy W on s in W: n:ry ocumkocd h, an i o F God n Awl Whid" Ql n i;.i� o 4�ir'x t "1n. t.. kFp o' J'� tn�� '4'our NOPPRIC 1q 1W dn' APH �"'ii �or wn" 0i A! 7) Walvey In AMC of NOW; U) &A upyl AW of die tenns m cand&: is ,.'on I :'0 to A p Agin lo he d'x-nwd to L61 Sol WY of nnh MpO n s OT I �jc 1 00 n Wo o �C, OT'haj Ube !.mad W he n0in, I J) Alsockadoa of I erms and (vaduklus Q Was wild voloviens rahey bar loan LOW Kn A am" I 1'jkQSMNhn" in oq v. f'o 31'.Od' fy fli'; f' cxvEdn�i� I PAQ on Selor Whom 0104 valoon AMICK 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 9121/2009 I Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount. 9/21/2009 S104654959. $12.87 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 Date Officer VOUCHER 096446 WARRANT 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 S 104654959.1 01- 7202 -06 $12.87 S i 76D. Q q. b o f 72,C©.03 Voucher Total Cost distribution ledger classification if claim paid under vehicle highway fund DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT CUSTONEIR NUMBER CUSTOMER NUMBER RELEASE NUMBER 74918 JEFF SALESPERSON SHIP VIA ORDERED BY SALES OFFICE PHONE NUMBER SHI DA TE MARK S BAYS WC51 WILL -CALL JEFF FISHERS 317 598 -6170 09/17/09 ORDERQTY 6ea 6ea ADVA VEL2S40SC351 16.22 lea 9712 ELE BALLAST (2) F40T12 277V KRDP 6ea 6ea PHIL MH400 /U 6PK 13.08 lea 78.48 1.57 344150 MH400 /U 6PK 344150 Billing Questions: Billing_request @kirbyrisk.com (765) 446 3054 sne+zoass:ao:dsPM S10d6776d6.001 Invoice Number 6104671646.001 Subtotal 175.80 If paid by 10/10/09 you may deduct $1.57 S&H Charges 0.00 Invoice is due by 10/31/09 net of any cash discount. Sales Tax 0.00 JEFF a 175.80 0001:0001 Kirby Risk Page 1 of 1 nams ;sNu cowrr�(.r�s OF SAJILE ACCAPTANCE (IV FRE QW98 PURCEASED 0' 'IIUS A CC MAN CEM TI I ETE R NIS ANOCENDmONSur Mix %NsiM PM .0n, SIG01; MerchowNse iN slow to a ratin �1""I' 1 !�Mlwrwhandise is in! renniahl wiksv vve c an secon; a 101u ms! Owds WAvay Axl (3) Tim clower DAMMOdpa nd a MY K wj "F r'(� ur impHvd spawaW o0wrOulaMy 8nc too Ns V Y u on WM'a' pwpvc. (4) 1 fig MAwner igreir Selb, w, no be ]i1 P) ar I wrq�. Ma Ony "XNY a�wchmvl wah dy jyMpawhowd Moo] SAW, (5) Tutus prim Nrol,n t o WO taws Kwund.iii to U rU.s ds Turi w" or `to- Vi rm akm o"hip-was wq! bo KIM to tho Ian chow pho BaywagrewN ol s iaN o; Q this) in 14MY SM i, my io in 'My Ov a Own RM has in Mitt,,'. CuAn! 17,10" Qlawn (M JAVAY Aw" W? Jn� be, 201wo2s 0 SUITAWS, Ond in 00 cen WAI &Air be KM on aly womaqwqw1i W` Pwk (71 WaMr 1 A Hurt 1100 er in W01 t>( pAl inc ptKonnner ;7. w7 Mw no ws im cNOUms cq cQ :a!� r.iy. dMI-rlui be b awn4w; on yo a do nay, oar Arid n o dw2nd w he wnatl any Mr wiw cavOm o: Aw WdMuahn of forms and (>nOft)ons and COWOM whal mor th"n 1 w"d he vin and KI ally WT PWPNII to ,1 di kne tons. or .100y; JaH he Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) y 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 9/24/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/24/2009 S104671646, $175.80 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 q lzs f 5- Date Officer VOUCHER 096480 WARRANT ALLOWED 174,1325 IN SUM OF KIRBY RISK SUPPLY CO PO BOX 664117 INDIANAPOLIS, IN 46266 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR I� u Board members PO INV ACCT AMOUNT Audit Trail Code S104671646.1 01- 7202 -06 $17530 Voucher Total $175.80 Cost distribution ledger classification if claim paid under vehicle highway fund