177435 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 00352777 Page 1 of 1
0 ONE CIVIC SQUARE USA BLUE BOOK
CARMEL, INDIANA 46032 PO BOX 9004 CHECK AMOUNT: $178.62
GURNEE IL 60031 -9004
CHECK NUMBER: 177435
CHECK DATE: 9/15/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 890802 178.62 OTHER EXPENSES
INVOICE A .M. Q
TEL: (847) 689 -9781 890802 1 of 1
I'
Remit to: e p FAX: (847) 689 -3001
ff P.O. Box 9004
TOLL FREE: 1- 800 493 -9876 R9/
urnee, IL 60031 -9004 i F.E.LN.: 36-3645787 936803 003/09
BILL TO: SHIP TO:
I' 936803 1
CARMEL UTILITIES CARMEL UTILITIES
760 3RD AVE SW STE 110 9609 HAZEL DELL PWKY
CARMEL, IN 46032 INDIANAPOLIS IN 46280
ATTN JEFF COOPER
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SALES
USTOMER P.O. NO. SHIP DATE SLP TERMS TAX CODE pRDER NO. W/H FREIGHT SHIP VIA
ERBAL 09/03/09 EAL NET 30 INEXEMPT 673910 01 PREPAID UPS
BACK
SA STOCK NO. DESCRIPTION ORDERED SHIPPED ORDER U/M PRICE PER EXTENSION
I 1 3018 1.5" Repl. Gaskets for NPSH 1 1 0 PK 4.94 PK 4.94
I Threaded Connection, pk of 10
!1 4984 Adjustable Hydrant Wrench 4 4 0 EA 21.25 EA 85.00
Fits Pentagon up to 1 -3/4
14217 Stream /Fog Nozzle 1 -1/2" NST 4 4 0 EA 18.50 EA 74.00
Polycarbonate RATED 100 PSI
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'THANK YOU for your business! o
1.5% MONTHLY FINANCE CHARGE -11=F
ON AMOUNTS 30 DAYS PAST DUE 163 94 .00 .00 .00 14 .68 1 178 .62
Discounts Apply to Merchandise Only
Should it become necessary to refer your unpaid balance to a collection agency, a collection fee, not to exceed 25% of the
I balance referr plu reasonable attorney's fees; and court costs when necessary, will be added to the balance due.
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
352777
USA BLUE BOOK Purchase Order No.
P.O. Box 9004 Terms
Gurnee, IL 60031 Due Date 9/9/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/9 /2009 890802 $178.62
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date O cer
VOUCHER 096378 WARRANT ALLOWED
IN SUM OF
3527`7
USA BLUE BOOK
P.O. Box 9004
Gurnee, IL 60031
Carmel Wastewater Utility
I9 ON ACCOUNT OF APPROPRIATION FOR
i
Board members
PO INV ACCT AMOUNT Audit Trail Code
890802 01- 7202 -06 $178.62
t
Voucher Total $178.62
Cost distribution ledger classification if
claim paid under vehicle highway fund