175150 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00351427 Page 1 of 1
t ONE CIVIC SQUARE STATE INDUSTRIAL PRODUCTS CHECK AMOUNT: $695.11
0 CARMEL, INDIANA 46032
PO BOX 74189
o CLEVELAND OH 44194 CHECK NUMBER: 175150
CHECK DATE: 7/22/2009
DEPARTMENT ACCOU PO NUMBE INV OICE NUMBER AM D
651 5023990 94240836 695.11 OTHER EXPENSES
Invoice PAGE: 1
World Headquarters
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3100 Hamilton Avenue 94240836 06!3012009 07/15/2009
W.- 1977 Cleveland, Ohio 44114 If you would like to receive your invoice via fax, please
800 782 -2436 contact our Customer Service Department.
State Chemical is a Division of State Industrial Products Your Fax number on file is: 317- 571 -2265
Our Customer Service Phone number is: 1- 800 782 -2436
00140214.29203 *C "512948319 "0357 1/1 II IIII{I IIIIIIIII III I III SHIP i0:
Ship -To No.: 518113 IF/ �1111116
Customer No.: 490452 �I
CARMEL SEWER DEPARTMEN CARMEL SEWER DEPT �clsrrsrto
ATTN: ACCOUNTS PAYABLE
760 3RD AVENUE SW STE #110 901 N RANGELINE RD 1509001:20001
CARMEL IN 46032 CARMEL, IN 46032 IS014001
I Certified
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Customer P.O.: paul arnone Sales Order: 3492903 Delivery: 800178172
Your Account Manager: 90148622 MICHAEL WELSH Taxable: N
ry
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0 3 3 S 114895 GENTLE FRESH HAND SANITIZER 1.70Z 221.000 663.00
0 1 1 S 11489$ G ENTLE FRESH HAND SANITIZER 1.702 0.00 0.00
1. IMPORTANT: Please return remittance portion
of invoice with your payment. To assure proper
credit to your account, ALWAYS include your Net Sales Shipfiing &Processing ,Sales Taic:: TOTAL:
customer number, invoice number, and amount
paid with your remittance. 663.00 32.1 1 0.00 695.1 i
2, All shipments FOB nearest warehouse.
3. Claims for shortage or damaged goods must be We hereby certify that these goods were produced in compliance with
made within 5 days after receipt of goods. all applicable requirements of Section 6, 7 and 12 of the Fair Labor
4. No returns without written authorization. Standards Act as amended, and of regulations and orders of the United
5. It you have any questions regarding this States Department of Labor issued under Section 14 thereof,
invoice please contact us at 1 -800- 782 -2436.
PAY NO MONEY TO AGENTS FOR CHEMICAL EMERGENCY SPILL,
LEAK, FIRE, EXPOSURE OR ACCIDENT
FED. TAX I.D. NO.
All tax exempt customers CALL CHEMTREC DAY OR NIGHT
34- 0552740 must submit tax exempt (800) 424 -9300
certificate with payment.
VOUCHER 096003 WARRANT ALLOWED
351427 IN SUM OF
STATE INDUSTRIAL PRODUCTS /US E
P.O. BOX 74189
CLEVELAND, OH 44194
Carmel Wastewater Utility
I ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
94240836 01- 7200 -02 $695.11
i1
1
Voucher Total $695.11
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER V
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
351427
STATE INDUSTRIAL PRODUCTS/US ENGINEE Purchase Order No.
P.O. BOX 74189 Terms
CLEVELAND, OH 44194 Due Date 7/13/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/13/2009 94240836 $695.11
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 Officer