175029 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00351019 Page 1 of 1
ONE CIVIC SQUARE MOFAB INC.
CARMEL, INDIANA 46032 1415 FAIRVIEW STREET CHECK AMOUNT: $226.56
ANDERSON IN 46016 -3524 CHECK NUMBER: 175029
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 215004 226.56 MATERIALS SUPPLIES
1415 FAfRVIEW ST.
ANDERSON, IN 46016-3524
PHONE (765) 649 -5577
QUALITY SINCE 1958 i FAX: (765) 641 -1555
INVOICE
1 CUT PRIME RED PLASMA DA SHIP a STEEL WELD
BEND PRIME GREY CUTTING )U lh Ivrnorra�J
L2 224
O v L4 �/.�C -`i H
CUSSTOM ORDE NO. l u ORDEREB SO'LD BY f SHIP VI ORDER DAT E q INVOICE DATtU 9 3 L�C C CASH CHRG V 6 r1 `f �j �O t; 1
OTY. B.O. J DESCRIPTION UNIT PRICE AMOUNT
i
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TERMS: 15% RESTOCKING CHARGE ON RETURNED MATERIALS. ,J\ TAX
NO BACK CHARGES WILL BE ACCEPTED WITHOUT PRIOR APPROVAL. g'.J
1 PER MONTH OR 18% ANNUAL SERVICE CHARGE FOR ALL INVOICES OVER 30 DAYS: TOTAL
MOFAB, INC. IS NOT AN ENGINEERING FIRM AND ANY TECHNICAL ADVICE WE FURNISH WITH RESPECT TO THE USE OF MATERIAL
IS GIVE N WITHOUT CHARGE, AND WE SHALL HAVE NO OBLIGATION OR LIABILITY FOR THE ADVICE GIVEN OR THE RESULTS j
OBTAINED, ALL SUCH ADVICE BEING GIVEN AND ACCEPTED AT BUYER'S RISK.
THANK YOU FOR THIS ORDER. WE L OO K
12 i RECEIVE D TH IO
IN GOOD CONDITN
y� D1G�j DATE
A:
O� NK 1Nv
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,
price per unit, etc.
Payee
351019
MOFAB INC. Purchase Order No.
1415 FAIRVIEW STREET Terms
ANDERSON, IN 46016 -3524 Due Date 7/14/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/14/2009 215004 $226.56
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
VOUCHER 096035 WARRANT ALLOWED
351019 IN SUM OF
MOFAB INC.
1415 FAIRVIEW STREET
ANDERSON, IN 46016 -3524
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
215004 01- 7202 -06 $226.56
1
Voucher Total $226.56
Cost distribution ledger classification if
claim paid under vehicle highway fund