177877 09/29/2009 CITY OF CARMFL, INDIANA VENDOR: 00351747 Page 1 of 1
ONE CIVIC SQUARE TRI STATE BEARING CO INC
CHECK AMOUNT: $48.54
CARMFL, INDIANA 46032 PO BOX 4737
s;«a� EVANSVILLE IN 47724 -0737 CHECK NUMBER: 177877
CHECK DATE: 9/29/2009
DEPARTMENT ACCO PO NUMBER INVOICE NU MBER AMOUNT DESCRIPTION
651 5023990 323890 48.54 MA'T'ERIALS SUPPLIES
XR
r
TRI -STATE BEARING INVOICE
Shipped from:
2205 ENTERPRISE PARK PLACE
INDIANAPOLIS, IN 46218
PH317 -924 -3287 FX317- 924 -3561
Remit to: Number:..;; i. 323890
P.O.Box 4737
Evansville, IN 47724 -0737 Date 09121/09
CW Phone: 812 -425 -1336 Fax: 812 421 -6788 .age, 1
r Bill.:To: Carmel Utilities Ship To Carmel Wastewater Treatment PI
.7030 760 3rd Ave SW Ste 110 -jj 9609 Hazel Dell Pkwy
Carmel, IN 46032 a Indianapolis, IN 46280
Refe rence pp sperson Terms Tax, Code Doc Wh Freight Shrp Via
Shr ed Sale
JEFF C 09/18/09 ZI House Indi NET 30 DAYS X 993763 07 PRE /ADD UPS DIRECT
Item; Description Ordered Shipped Backordcd ;UM Price ,C/Nl'' Extension
USS USP- 050001303 *STYLE 303 GRAPHITE! 1.00 1.00 .00 LB 42.24 LB 42.24
PACKING
I
Merchandise Mrsc i yDiscoun Tax. Freight: Due'
z,
42.24 .00 .00 6.30 48.54
WE APPRECIATE YOUR BUSINESS
F r7 rescribed by Board of
Form' j3015 State Accounts ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I 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
19
Signature Title
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.
Officer Title
Voucher No. Warrant No.
ACCOUNTS BILE DETAILED ACCOUNTS
SANITATION DEPARTMENT ACCT.
Y '17 CAARMEL, INDIANA NO.
Favor Of
Ale I
Ovx� 3-7
sU
Total Amount of Voucher
Deductions
WO
6
Amount of Warrant
Month of 19
Acct,
VOUCHER RECORD No.
Collection System
Operation
Plant
Commercial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts Merchandise
Total
Allowed
Board Members
Filed
BOYCE FORMS SYSTEMS 1 -800- 382 8702 325