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169549 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 221001 Page 1 of 1 ti1 ONE CIVIC SQUARE NEENAH FOUNDRY CORP CHECK AMOUNT: $236.00 ia CARMEL, INDIANA 46032 PO Box 729 NEENAH WI 54957 CHECK NUMBER: 169549 CHECK DATE: 3/4/2009 DEPAR AC COUNT PO NUMBER INVOICE N UMBER AMOU DESCRIPTION 206 4237001 870950 118.00 STORM SEWER MAINT SUP 206 4237001 870992 118.00 STORM SEWER MAINT SUP f ORIGINAL NEENAH FOUNDRY w O 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 'f OT CARMEL STREET DEPT YARD PICK —UP o D 8400 W i3iST STREET D` WESTE I ELD I iV 46074 PAGE i PLEASE REFER TO INVOICE NUMBER CUSTOMER NUMBER ON ALL CORRESPONDENCE CONCERNING THIS INVOICE ROUTING PURCHASE ORDER JOB NUMBER DATE SHIPPED INVOICE NUMBER CUSTOMER NO: CUSTOMER PICK —UP 48494 2/17/09 870950 C13200 QUANTITY- PART NUMBER CATALOG DESCRIPTION PRICE AMOUNT 1 32877001 3287 CURB BOX 118.00 EA. 118.00 SUB —TOTAL ii8.00 METAL SURCHARGE: 000 /LB X 124 .00 TOTAL 118.00 1379 98 I. 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 LASS 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 -0NBILLED,IS THE OBLIGATION OF THE PURCHASER. 6: SELLER. HEREBY CERTIFIES THAT THE ABOVE. MATERIALS WERE PRODUCED '.INCONFORMITY WITH THE FAIR .LABOR STANDARDS ACT OF 1938, AS AMENDED. S:LIMRATION 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. ORIGINAL NEENAH FOUNDRY V O c 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 J O r CARMEL STREET DEPT YARD PICK -UP OT Lo 3400 W 131ST STREET D WESTFIELD IN 46074 PAGE 1 PLEASE REFER TO INVOICE NUMBER CUSTOMER NUMBER ON ALL CORRESPONDENCE CONCERNING THIS INVOICE ROUTING PURCHASE ORDER JOB NUMBER DATE SHIPPED INVOICE NUMBER CUSTOMER NO. CUSTOMER PICK -UP 131ST HAZEL D 4949e 2/19/09 870992 C13200 QUANTITY PART NUMBER CATALOG DESCRIPTION PRICE AMOUNT 1 32877001 3287 CURB BOX 118.00 EA. 118.00 SUB -TOTAL 118.00 METAL SURCHARGE: .000 /LB X 124 .00 TOTAL 118.00 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. 5.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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 02/17/09 870950 $118.00 02/18/09 870992 $118.00 1 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 N WARRANT NO. ALLOWED 20 Neenah Foundry IN SUM OF Box 729 Neenah, W 1 54957 $236.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 206 870950 42- 370.01 $118.00 1 hereby certify that the attached invoice(s), or 206 870992 42- 370.01 $118.00 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 r F d'ay ruary 27, 2009 r, Str i rPee, loner U?7�r"i fissiorSt�r Title Cost distribution ledger classification if claim paid motor vehicle highway fund