173928 06/24/2009 a CITY OF CARMEL, INDIANA VENDOR: 00350691 Page 1 of 1
ONE CIVIC SQUARE MACHINE DRIVE COMPANY
CARMEL, INDIANA 46032 PO Box 569
CHECK AMOUNT: $260.71
AKRON OH 44309
CHECK NUMBER: 173928
CHECK DATE: 6/24/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 W08784 F27444 -001 260.71 MOTOR
.1
f
4
a INVOICE
MAIL REMITTANCE TO: ENTERING OFFICE INVOICE NUMBER CODE
B W R EDR DR F27444 -001 of
0 M P A N Y MACHINE DRIVE DIV DISTR
15402 STONY CREEK WAY INVOICE DATE PAGE
P.O. Box 569 Akron, Ohio 44309 NOBLESVILLE IN 46060 06/09/09 1
For Terms end Corditioris visit: iivrvrv.bvwrogers.com Any dillerent or edditionat terms that may be embodied in your purchase order are hereby objected to. It your order is rot an
acceptance of our proposal, this will operate as an acceptance c1 your order only in the event you agree to the terms hereo I.
The terms and conditions contained above and anached shell apply.
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10 1 1 101780.00
247.1000 247.10
MOTOR L30 EA
INBOUND FRT IS: .00
FOLD
COST. NO. ORDER DATE TERR PC 0 R1 Written By DATE SHIPPED WHSE
AMOUNT 247.10
C4037 05/20/09 98 10 S JSC 06/03/09 10
FRGHTIINSlHNDL 13.61
Carrier: Fed Ex Foe: SP,FNA,PREPAID ORIG FAX INVOICE SALES TAX .00
Tracking:
Terms of Payment: NET 30 DAYS CUST FAX#: 317 -733 -2053 INVOICE TOTAL 260.71
Raw Pay This A—nt
ORDER ISSUED IN: NOBLESVILLE
PHONE: 317- 776-2900
Customer PO No. PLT3- 052009A -BST Mark No. PLT3- 052009A -BST
s CITY OF CARMEL UTILITIES s CITY OF CARMEL UTILITIES
O ATTN A/P H ATTN BRIAN TOLAN
D 3450 W 31 ST ST P 3450 W 31 ST ST
T WESTFIELD IN 46074 T WESTFIELD IN 45074
o
0
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 U
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
350691
MACHINE DRIVE COMPANY Purchase Order No.
PO BOX 569 Terms
AKRON, OHIO 44309 Due Date 6/10/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/10/2009 F27444 -001 $260.71
pi
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 092059 WARRANT ALLOWED
.350691 IN SUM OF
MACHINE DRIVE COMPANY -AI
ell BOX 569 co
AKRON, OHIO 44309
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
F
F27444 -001 01- 6200 -04 $260.71
Voucher Total $260.71
Cost distribution ledger classification if
claim paid under vehicle highway fund