168126 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 221001 Page 1 of 1
ONE CIVIC SQUARE NEENAH FOUNDRY CORP
s is CARMEL, INDIANA 46032 PO Box 729
CHECK AMOUNT: $398.00
NEENAH WI 54957
CHECK NUMBER: 168126
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUM AMOUNT DESCRIPTION
206 4237001 869679 398.00 STORM SEWER MAINT SUP
c�,
ORIGINAL
NEENAH FOUNDRY
N M
V 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
OT CARMEL STREET DEPT YARD PICK —UP
Lo
D 3400 W 131ST STREET
WESTFI_ELD 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 48405 1/05/09 869679 013200
QUANTITY PART NUMBER CATALOG DESCRIPTION PRICE AMOUNT
1 33050001 3305 FRAME P3305 -399 296.00 EA. 296.00
1 33050003 3305 VENTED LID P3305 -399 102.00 EA. 102.00
SUB -TOTAL 398.00
METAL SURCHARGE: .000 /LB k 413 .00
TOTAL 398.00
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 COAS NOT RESPONSIBLE. FOR LOSS OF OR DAMAGE. TO PATTERNS 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 THEPURCMASER DIRECTLY TO THE GOVERNMENTALAGENCY 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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/05/09 869679 $398.00
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 NOt WARRANT NO.
Neenah Foundry ALLOWED 20
IN SUM OF
Box 729
Neenah, WI 54957
$398.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Member:
206 869679 42- 370.01 $398.00 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
Saturday/Ja ua�, 17, 200f
iI
Street Commissio of
t ?vi rissloner
Cost distribution ledger classification if
claim paid motor vehicle highway fund