180900 12/30/2009 VENDOR: 221001 Pa e 1 of 1
CITY OF CARMEL, INDIANA g
ONE CIVIC SQUARE NEENAH FOUNDRY CORP CHECK AMOUNT: $1,135.16
CARMEL, INDIANA 46032 Po Box 729
NEENAH WI 54957 CHECK NUMBER: 180900
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 4237001 4236 1,135.16 STORM SEWER MAINT SUP
Neenah Foundry N E E N A H FOUNDRY
INVOICE "Word on the Street is Neenah"
Terms: Net 30 Payable in U.S. Dollars FEIN 39- 1580331
Remit To: Neenah Foundry Company
Invoice No.: 4236 Box 729
Neenah, WI 54957
'4 Invoice Date 12/18 Phone: 800 558 -5075
Fax: 920-729-3682
Sold To: Shipped To:
CARMEL STREET DEPT CARMEL STREET DEPT
3400 W 131ST STREET 3400 W 131ST STREET
WESTFIELD IN 46074
WESTFIELD IN 46074
PAGE 1
Customer Routing Carrier PO No. Job No. Date Shipped
C13200 PREPAID U HOLLAND INC DAVE 25755 12/15/ -09
Qty I Part Number Catalog Description Price Amount
2 39200001 3920 -V SCUPPER P3920 -500 531.00 SET 1,062.00
2 39200007 GRATE P3920 -500
SUB -TOTAL 1,062.00
METAL SURCHARGE: .000 /LB X 518 .00
FREIGHT 73.16
TOTAL 1,135.16
1375 98
1. Claims for emars in weight or number must be made within ten days afterthe 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, his to be paid by the purchaser directly to the governmental agency assessing the tax. Any sales, use, occupational, a similar tax
imposed on this sale, it unfilled, 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. INVC
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))
12/15/09 4236 $1,135.16
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. WARRAN N
ALLOWED 20
Neenah Foundry
IN SUM OF
Bo,x 729
Neenah, WI 54957
$1,135.16
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
206 4236 42- 370.01 $1,135.16 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
1 Wed sday, December 23, 2001
Street Commissio r
Title inner
Cost distribution ledger classification if
claim paid motor vehicle highway fund