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207966 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 00351019 Page 1 of 1 ONE CIVIC SQUARE MOFAB INC. CHECK AMOUNT: $94.72 CARMEL, INDIANA 46032 1415 FAIRVIEW STREET ANDERSON IN 46016 -3524 CHECK NUMBER: 207966 CHECK DATE: 4/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 232316 94.72 OTHER EXPENSES 1415 FAIRVIEW ST. ANDERSON, IN 46016 -3524 P H O N E (765) 649 -5577 2 3" 1 QUALITY SINCE 1958 FAX: (765) 641 -1555 1. n INVOICE STEEL CUT WELD PRIME R ED PLASMA D O IP m BEND PRIME GREY CUTTING S 3d lea- S er 1 H Y1(>� �Y�.c tai. �-P �o o CUSTOMER ORDER NO. ORDERED BY SOLD' B Y SHIP'VIA ORDER DA T INVOICE DATEC� CASH CHRG ,r•i� I !�a`/ QTY.. B.O. ;�i =�r /Q DESCRIPTION /(7 v UNIT PRICE AMOUNT Lam.- 3x f, q9g X 0 1 1 -1 79 TERMS: 15 RESTOCKING CHARGE ON RETURNED MATERIALS. TAX NO BACK CHARGES WILL BE ACCEPTED WITHOUT PRIOR APPROVAL. c 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 GIVEN WITHOUT CHARGE, AND WE SHALL HAVE NO OBLIGATION OR LIABILITY FOR THE ADVICE GIVEN OR THE RESULTS OBTAINED, ALL SUCH ADVICE BEING GIVEN AND ACCEPTED AT BUYER'S RISK THANK YOU FOR o RECEIVED THE ABOVE-IN CONDITION DATE ORIGINAL INVOICE VOUCHER 117071 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 232316 01- 7200 -03 $94.72 Voucher Total $94.72 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 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 4/2/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/2/2012 232316 $94.72 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 7 ii Lruo"" .r Date Officer