168623 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 221001 Page 1 of 1
ONE CIVIC SQUARE NEENAH FOUNDRY CORP
Is CHECK AMOUNT: $183.15
s CARMEL, INDIANA 46032 Po eox 729
NEENAH WI 54957 CHECK NUMBER: 168623
CHECK DATE: 2/4 /2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 4237001 52987 183.15 STORM SEWER MAINT SUP
it
I
ORIGINAL
V NEENAH FOUNDRY
N w 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 CARMEL STREET DEPT CARMEL STREET DEPT
O T
LO 3400 W i3lST STREET 3400 W i3iST STREET
D WESTF IN 46074 PAGE i
WESTF I EL D IN 46074
PLEASE REFER TO INVOICE NUMBER CUSTOMER NUMBER ON ALL CORRESPONDENCE CONCERNING THIS INVOICE
ROUTING PURCHASE ORDER JOB NUMBER DATE SHIPPED INVOICE NUMBER CUSTOMER NO.
UNITED PARCEL PPD 07445 1/06/09 52987 013200
QUANTITY PART NUMBER CATALOG DESCRIPTION PRICE AMOUNT
1. 17205017 1720—A SOLID PLATEN LD 1.23. 00 EA. 123.00
SUB —TOTAL 123.00
METAL.SURCHARGE: .000 /LB X 1i2 .00
FREIGHT 60.15
TOTAL 183.15
].379 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.
S.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
9
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/06/09 52987 $183.15
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 NO. WARRANT NO.
ALLOWED 20
Neenah Foundry
IN SUM OF
Box 729
Neenah, WI 54957
$183.15
J ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
206 52987 42- 370.01 $183.15 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
Thur day uary 29, 2009
Street Commps" ner
S :-t Cu TI l jf stoner
Cost distribution ledger classification if
claim paid motor vehicle highway fund