179739 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 174625 Page 1 of 1
t` ONE CIVIC SQUARE KIRBY RISK SUPPLY CO
i CHECK AMOUNT: $1,702.40
CARMEL, INDIANA 46032 Po BOX ss4ln
INDIANAPOLIS IN 46266-4117 CHECK NUMBER: 179739
CHECK DATE: 11/24/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION
651 5023990 S11888 S10474941700 1,702.40 UNISTRUT
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DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
74918 S11888
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SALESPERSON SHIP VIA'
MARK S BAYS PK PICK -UP JEFF COOPER FISHERS 317 598 -6170 11/09/09
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ITE
250ft 250ft BLIN B22 -10FT -ALUM 680.96 100ft 1702.40 17.02
1 -518" X 1 -518" ALUM STRUT
Billing Questions: Billing (765 446 -3054 1108f20091202 PM s104749417.001 Invoice Number S104749417.001
Subtotal 1702.40
If paid by 12/10/09 you may deduct $17.02 f S &H Charges 0.00
Invoice is due by 12/31/09 net of any cash discount. Sales Tax 0.00
JEFF EOO FER 1702.40
702.40
0001:0001 Kirby Risk Page 1 of 1
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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 11/17/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/1712004 S104749417. $1,702.40
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 096751, .,WtARRANT 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
S104749417.( 01- 7202 -06 $1,702.40
Voucher Total $1,702.40
Cost distribution ledger classification if
claim paid under vehicle highway fund