169194 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 00352777 Page 1 of 1
fi ONE CIVIC SQUARE USA BLUE BOOK
CARMEL, INDIANA 46032 PO BOX 9004 CHECK AMOUNT: $126.02
y r. GURNEE IL 60031 -9004
CHECK NUMBER: 169184
CHECK DATE: 2117/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 750243 126.02 OTHER EXPENSES
*i y
W A-BlueBoollf INVOICE INVbICEiNO. 'PAGE NO.
TEL: (847) 689 -9781 750243 l of 1
Remit to: FAX: (847) 689 -3001
P.O. Box 9004 TOLL FREE: 1- 800 493 -9876 e
Gurnee, IL 60031 -9004 F.E.L1�".: 36 3645787 1.63145 01/30/09
BILL TO: SHIP TO:
163145 4
CARMEL UTILITIES CARMEL UTILITIES
3450 W 131ST ST 3450 W 131ST ST
WESTFIELD, IN 46074 WESTFIELD, IN 46074
ATTN PO# DAN
C.USTOMER`P.O.:'NO SHIP DATE SLP� TERMS TAX CODE, 'oRDE� N4. W/11 FREIGHT SHIP7_
DAN JENKINS 01/30/09 AEA NET 30 INEXEMPT 563137 01 PREPAID UPS
USASTO,
STOCK NO.' F DESCRIPTION= ORDERED SHIPPED ;oROi R =U /M. =PRICE' PEFi EXTLNSION°
48469 Dr. Martens 6" Steel -Toe Boots 1 1 0 PR 114.00 P 114.00
Black, Size 10
HC Hard Copy 1 1 0 EA .00 E .00
THANK YOU for your business! DISC
1.5% MONTHLY FINANCE CHARGE
ON AMOUNTS 30 DAYS PAST DUE 114.00 .00 .00 00 12.02 126.02
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
balance referred plus 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, p
price per unit, etc.
Payee
352777
USA BLUE BOOK Purchase Order No.
PO BOX 9006 Terms
GURNEE, IL 60031 -9006 Due Date 2/9/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/9/2009 750243 $126.02
I 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
Date Officer
VOUCHER 091035 WARRANT ALLOWED
352777
IN SUM OF
USA BLUE BOOK
PO BOX 9006
GURNEE, IL 60031 -9006 �'L
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
750243 01- 6200 -03 $126.02
Voucher Total $126.02
Cost distribution ledger classification if
claim paid under vehicle highway fund