177779 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 221001 Page 1 of 1
ONE CIVIC SQUARE NEENAH FOUNDRY CORP CHECK AMOUNT: $405.00
CARMEL, INDIANA 46032 Po Box 729
.roN `o NEENAH WI 54957 CHECK NUMBER: 177779
CHECK DATE: 9/29/2009
DEPARTM ACCOUNT PO NUMBER INVOICE NU A DESCRIPTION
206 4237001 884924 405.00 STORM SEWER MAINT SUP
4�
ORIGINAL
NEENAH FOUNDRY
N M
V G 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
OT CARMEL STREET DEPT YARD PICK —UP
LQj 3400 W i3iST STREET
D
W ESTf IELD IN 46074 PANE I
PLEASE REFER TO INVOICE NUMBER CUSTOMER NUMBER ON ALL CORRESPONDENCE CONCERNING THIS INVOICE
ROUTING PURCHASE ORDER JOB NUMBER DATE SHIPPED INVOICE NUMBER -0 USTOMER NO.
CUSTOMER PICK —UP 1 491334 9/18/09 884924 C13200
QUANTITY PART NUMBER„ CATALOG DESCRIPTION PRICE AMOUNT
1 32862000 3286 —SV FRAME P3286 -462 405.00 SET 405.00
1 32860018 GRATE P3286 -462
1 32867001 CURB BOX P3266 -462
SUB —TOTAL 405.00
METAL SURCHARGE: 000 /LB X 350 .00
TOTAL 405.00
1375 98
t. CLAIMS FOR ERRORS IN WEIGHT OR NUMBER MUST BE MADE WRHINaTEN 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 00 NOT INCLUDE SALES, USE, OCCUPATIONAL OR SIMILARTAX 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.
0, SELLER HEREBY CERTIFIES THAT THE ABOVE MATERIALS WERE PRODUCED IN CONFORMITY WITH THE FAIR LABOR STANDARDS ACT OF 1938, AS AMENDED.
S.LIMffAT10N OF DAMAGES: UNDER NO CIRCUMSTANCES WILL NEENAH FOUNDRY CO. BE flESPONSIBLE FOR INCIDENTAL OR CONSEQUENTUIL DAMAGES ARISING FROM OR IN CONNECTION WITH,THE:USE OF, ANY,NEENAH FOUNDRY CASTING F.
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 J
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/18/09 884924 $405.00
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 NO. WARRANT NO.
ALLOWED 20
Neenah Foundry
IN SUM OF
Box 729
Neenah, WI 54957
$405.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
206 884924 42- 370.01 $405.00 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
1
T ursday ept r 24, 2009
f.
y
Str
u4, nmissiona
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund