172955 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 221001 Page 1 of 1
ONE CIVIC SQUARE NEENAH FOUNDRY CORP CHECK AMOUNT: $586.00
CARMEL, INDIANA 46032 PO BOX 729
NEENAH WI 54957 CHECK NUMBER: 172955
CHECK DATE: 5/27/2009
D EPARTMENT J A CCOUNT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
206 4237001 874268 586.00 STORM SEWER MAINT SUP
ORIGIN L
M NEENAH FOUNDRY
Box 729, Neenah, WI 54957
Phone 800 -558 -5075 Fax 920 729 -3682
TERMS NET 30 DAYS "Word on the street is Neenah"
SHIP TO (IF DIFFERENT FROM SOLD TO)
S
OT CARMEL STREET DEPT YARD PICK -UP
D 3400 W 131ST STREET
WESTFIELD IN 46074 PAGE i
PLEASE REFER TO INVOICE NUMBER CUSTOMER NUMBER ON ALL CORRESPONDENCE CONCERNING THIS INVOICE
ROUTING PURCHASE ORDER JOB NUMBER D INVOICE NUMBER CUSTOMER N0.
CUSTOMER PICK -UP 48816 2
QUANTITY PART NUMBER CATALOG DESCRIPTION PRICE AMOUNT
1 35010140 3501 -N ROLL FRAME' P3501 -505 284.00 SET 284.00
1 35010146 ROLL GRATE P3501 -505
1 35010146 350i -N ROLL GRATE 119.00 EA. i19.00
1 34720003 3472 GRATE 183.00 EA. ie3.00
SUB -TOTAL 586.00
METAL SURCHARGE: 000 /LB X 632 .00
TOTAL 586.00
1379 98
1. CLAIMS FOR ERRORS IN WEIGHT OR. NUMBER MUST BE MADE WITHIN TEN DAYS AFTER THE RECEIPT OF THE CASTINGS.
2. NEENAH FOUNDRY CO. IS NOT RESPONSIBLE FOR LOSS OF OR DAMAGE TO PATTERNS BY FIRE OR OTHER CASUALTIES, IT SHALL BE THE OBLIGATION OF THE CUSTOMER TO INSURE HIS EQUIPMENT WE DO NOT INSURE CUSTOMERS' PATTERNS.
3. PRICES DO NOT INCLUDE SALES, USE, OCCUPATIONAL OR SIMILAR TAX. IF ANY TAX OF THIS NATURE IS IMPOSED ON THIS SALE, IT IS TO BE PAID BY THE PURCHASER DIRECTLY TO THE GOVERNMENTAL AGENCY ASSESSING THE TAX, ANY SALES,
USE, OCCUPATIONAL, OR SIMILAR TAX IMPOSED ON THIS SALE, IF UNBILLED, IS THE OBLIGATION OF THE PURCHASER.
4. SELLER HEREBY CERTIFIES THAT THE ABOVE MATERIALS WERE PRODUCED IN CONFORMITY WITH THE FAIR LABOR STANDARDS ACT OF 1938, AS AMENDED.
&LIMITATION OF DAMAGES: UNDER NO CIRCUMSTANCES WILL NEENAH FOUNDRY CO. BE RESPONSIBLE FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING FROM OR IN CONNECTION WITH THE USE OF ANY NEENAH FOUNDRY CASTING.
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. 1
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/04/09 874268 $586.00
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
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Neenah Foundry
IN SUM OF
Box 729
Neenah, WI 54957
$586.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
206 874268 42- 370.01 $586.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday; May 21, 2009
V
r
r
Street Gommission&
r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund