180160 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 00351017 Page 1 of 1
ONE CIVIC SQUARE KIRBY RISK ELECTRICAL SUPPLY
I CARMEL, INDIANA 46032 PO BOX 664117 CHECK AMOUNT: $296.12
INDIANAPOLIS IN 46266
CHECK NUMBER: 180160
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 S104709403 86.22 OTHER EXPENSES
610 5023990 S104710320 209.90 OTHER EXPENSES
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
s NUMBE RELEASE NUMBER
11788 KR100909 /PLT#4CL2
SALESPERSON'
KENNETH R WALTERS PAR PARCEL DLVY KEN RHODES INDIANAPOLIS 317 687 -0015 10/22/09
ORDER QTY SHIP Q
NIT VXT AMOUNT CASH ISC
IjEM I'll
5000ea 5000ea PAND S10OX125VAlY 29.69 1000ea 148.45
THERMTRANS, SELF -LAM LABEL, VINYL,
1.00
SUBJECT TO VENDOR RETURN POLICY
15ea 15ea BUSS MDA -1 2.47 lea 37.05
250V SMALL DIM FUSE
l0ea 10ea BUSS MDA -3 2.44 lea 24.40
250V SMALL DIM FUSE
Billing Questions: Billing_request @kirbyrisk.com (765) 446 -3054 Invoice Number S104710320.001
Subtotal 209.90
S&H Charges 0.00
Invoice is due by I V21109. Sales Tax 0.00
ID B 209.90
0001:0001 Kirby Risk Page 1 of 1
IFERNISAN'D kC,'()N!UTR)NxJ OF SALE
ACULPFANCE OF THE (NUMPURCMASEDON
ACCTPIANCk OFTHE I MOR vAN D SALE'*NH I CH FOLLOW:
01
(2) ARMAM NivrehawhNe ncL wnuM Law WSW lye Cn seLw
zoo scop",
ndalva Rohn P puiMeMpUp ud w6us key SaYn Sdw
or
Cusulmn SCLr -,"20; n., T bs",
Any A owu wo wed w1h the jpv& pywhand Kim KwAr,
J of od OWPW Twon ""A
001we MAY Ax a! Nwh wx or providv SAW WE ac.phyle NX 1worpdon 0.13nn.
f6) P Iay i? O'Milvry NOW ma 0 he OWNWYNO Q nhys 5 i y l.ios
OVOr ""JNol s6lc Jh�ploc.n!
Kea onnow oFmu nqTlmn *I in vo can SO ScHn bo Elk Pw a, ccw"n Er. iul or *wwi
(7) 'Xiiier I Y hOwn Me% V) MY prm ihe of on Mw wnw ru cmdobw of Q,
c anon coo combs aid; Agh hawwA T AYH M be dunwd W K a w1va
A bt: jecnl�;d ?,C) bc "Z Yvi:'r of el 1"'u; o� a o,
IN i!',7
dificAti4w of Orms and CKMOSS to wnn,
agrawn w widw=n1ing, inajk LV,')V lo
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
CUSTOMER IN RELEASE NUMBER
11788 PPE FOR KEN
SALESPERSON'. SHIP VIA:. ORDERED BY SALES OFFICE PHONE NUMBER SHIP DATE
KEVIN R FORD PAR PARCEL DLVY BRIAN TOLAN INDIANAPOLIS 317 687 -0015 11/13/09
ORDER ,QTY SHiP dw; DESCRIPTION
lea lea CERT 51301 52.99 lea 52.99
Size 9.5 Class 00 (500V Max) 11"
Gloves
"SUBJECT TO VENDOR RETURN POLICY
lea lea CERT 51293 27.63 lea 27.63
Size 9.5 -10 10" Leather Class 00
Protectors
KRPNM
"SUBJECT TO VENDOR RETURN POLICY"
Billing Questions: Billing (765) 446 -3054 Invoice Number S104709403.001
Subtotal 80.62
S &H Charges 5.60
Invoice is due by 12/13/09. Sales Tax 0.00
86.22
0001:0001 Kirby Risk Page 1 of 1
ANDCONDITIONS OFSAII.E.
ACCEPTANCE OF THE MUMS PURCHAN't-.11) ONI IMS INVOK. F(:'ONS I-VFUT,F-S AND
ACCEPTANCE ou TIONIS ATO) CA)WITONS OF SAI. E WHICH MUMV:
01 Sawk NkMamRw I suNed m a rvarn chm, Ni goodsni-i b v,:ifunoni ?�i 1:1 ticks
is ion lounnho UAWS viv Mn SMUN a "Mand ("M AUNW41 !Wn
13) M 11 U.WW; Wk on, '111"! ths in aU punhaws cif'goxk ano. from s✓lIek
o! ilrpli' d Wasamno and post K ny j"4041f
t 4 ._n C thi SWx KH no be hdk if in�:
(51 Runs Wrown do my mcludc' sui(5oi othei !,ixcs inipo,-cd on Ow UpWA Twc wv ot
Ol'i'MI sales or shipwas it i be added to the javchase Imice. Btqcrapcvv)
"'�Cller for wV suh to or p Sellar %vith accclitable .'ax
0) Delay in lf') Iiviixy SAW is n(A to be anonmablu Or (Ilays in ikliii-;'Y ocmasiorick.'i by of'(;od oY
(min Onw ovar which SO& hus no dOw awnw? fActory ship riwia (m dchvcq Mins aim Lhf,'
hum WOW Of Oil sulTIVrS in nO case shvil SWRr he hahk Q aq: wnwqwnQA oT Ta%i�
dania�,""-S ai fir"nn, ;Iffll� in de"'livul
(7) Waiver I hc OR= oi'ScHer to inski tWon!he perfoririance of 'any oftfic ICTIES 01' O"i"ditions oft].Iis
s'onli or toe,1C't 1:.:. any 6ght hemwider W no hot Aenwd to he a vni"i: oWh ierns,
in the fuumn nm ME A he Wni%I LO 1.)C,.1 Vv;Ii 0.1 .inn oth..t: r t 1iT cotudilion., or
g l'v un�dcr this
IsIvirms and Clynd"Ans TO Wriniand othei t nos: s;Mcd and
no aqvOnCT or UIACUNW, in sly "my PUT(virig ;"'odi G" dflose i 11: s' of con-'I h�"ns.
Wding Oil SeW ol;o�r c*� "00 consen,
Prescribed by State Board of Accounts City Form No. 201 (Rev 1993),
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
351017
KIRBY RISK ELECTRICAL SUPPLY Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 11/30/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/30/2W S104709403 $86.22
�1
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
VQUCHER 093704 WARRANT ALLOWED
11
3'5'1017 IN SUM OF
KIRBY RISK ELECTRICAL SUPPY
PO BOX 664117
INDIANAPOLIS, IN 46266
6_
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
S104709403 01- 6200 -04 $86.22
J Voucher Total gb 1-7- $86.22
Cost distribution ledger classification if
claim paid under vehicle highway fund