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169663 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 362633 Page 1 of 1 ONE CIVIC SQUARE UNITED ROTARY BRUSH CORP 0 CARMEL, INDIANA 46032 PO BOX 413198 CHECK AMOUNT: $365.39 KANSAS CITY MO 64141 CHECK NUMBER: 169663 t CHECK DATE: 3/4/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 C/87229 365.39 REPAIR PARTS INVOICE East Location Central Location 20078 State Route 4 15607 West 100th Terrace Remit to: Marysville, Ohio 43040 Lenexa, KS 66219 P.O. Box 413198 UMTM 937- 644 -3515 913- 888 -8450 KANSAS CITY, MO 64141 B WSH 800- 851 -5108 800- 851 -5108 Fax: 937 -642 -3552 Fax: 913-541-8310 Invoice ID: C187229 www.united- rotary.com West Location EPD Date: 211712009 160 Enterprise Ct Ste A 20078 State Route 4 Order No: C082738 Galt, CA 95632 8795 Marysville, Ohio 43040 Page No: 1 FEDERAL E.I.N 48- 0945667 209 -744 -4200 800- 896 -0003 F.O.B PPDIADD 800- 851 -5108 Fax: 937- 642 -3552 Fax: 209 -744 -2904 a =."k a it� Sold Toy ;Sht �r:�..: Carmel City ICarmel Street Department 3400 W 131 st St 13400 W 131st St f (Street Dept lWestfield, IN 46074 f Westfield, IN 46074 F "_Gt1ST0lVIER IO w „CUSTQMER PO xn PAYMENT TERMS a k`. s i FI.2_EIGHT� 203028 -"ef "021609 NET-30- PPD1ADD- b A „SALES REP'IDe_ A y W HOD PRO /JRACKIN01NiJMBER CCH IP „DATE �INUQICE DU D A7 tl i' 'K `&'^wv•t•.Fti.ei 1. UPS 211712009 3/19/2009 T� UNIT EXTENDED QUA ITY NT a 1Z4853810346296887 F SHP ,E_BCK ,d `P,4RTa .g 3 °a 4 �l)ESCRIP,TION yi a:. 'X .R,,aPRICE 3 !PRICE 1 ==boRn 1; w” w 1 1 0 21- 041551 JOP650 JOHNSTON 650 POLY TB 4 318X15.5X51 'SQDR $225.00 $225.00 Refer to packlist number: PACK89904 2 2 0 41- PATWWP2 BLUE STEEL WHIRLWIND 2 -SEG PLAS GB $51.69 $103.38 Refer to packlist number: PACK89904 X tr IFINS�.'.s:�:�.:. C�ATIO 3 SUB TOTAL: $328.38 FREIGHT CHARGES: $37.01 TOTAL AMOUNT DUE: $365.39 USD PLEASE INSPECT PROMPTLY. Claims for Credit or Adjustments must be made within 10 days after receipt of shipment. No return accepted without UNITED ROTARY BRUSH return material authorization number. �s 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)) 02/27/09 C/87229 $365.39 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 20 Clerk- Treasurer VOU NO. WARRANT NO. ALLOWED 20 United Rotary Brush Corp. IN SUM OF P. O. Box 413198 Xansas City, MO 64141 $365.39 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board MemberE 2201 C/87229 42- 370.00 $365.39 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 �iay, y,/e '1 r ry 7, 2009 zr S e 9MWer Title Cost distribution ledger classification if claim paid motor vehicle highway fund