209550 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 358126 Page 1 of 1
ONE CIVIC SQUARE GOLDSTAR PRODUCTS INC
e. S� CARMEL, INDIANA 46032 PO BOX 291630 CHECK AMOUNT: $1,683.17
DAVIE FL 33329 CHECK NUMBER: 209550
CHECK DATE: 615/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 49310 1,683.17 OTHER EXPENSES
SOLD TO:
PAULARNONE
CARMEL CITY SEWER WATER INVOICE: 0049310
760 3RD AVENUE SW
CARMEL, IN 46032 ORDER DATE: 4/21/2012
oldstar Prod I nc CUSTOMER NO: 0018098
P.O. BOX 291630 DAVIE, FL 33329 SALES REP ID: R01
SHIP TO:
PAULARNONE 1 -Soo- 239 -6699
CARMEL CITY SEWER WATER Tax ID 65- 0597470
901 NORTH RANGELINE
CARMEL, IN 46032
CUSTOMER P.O. SHIP VIA TERMS DUE DATE
PAULARNONE MOST ECONOMICAL NET 30 DAYS 5/21/2012
SHIPPED DESCRIPTION PRICE AMOUNT
2 SUPER HIGH HEAT -55 LBS 769.45 1,538.90
For your convenience, we accept the American? a
Express° Card and other major credit cards.
Please fill in the information bellow.
Mo. 1 00
Account Number Expiration D ate —il
X
Cardmember Signature Amount Date
MO V /SA im
—Plow 0
RETURNS SUBJECT TO 30% RESTOCKING CHARGE PLUS FREIGHT. N et Ord 1,5
Make Check Payable to Goldstar Products. No returns without written permission. No returns accepted after 30 days. No Exceptions. The parties 0.00
agree that any legal proceeding brought by either party in connection with or arising out of this invoice shall be brought in Broward County, Florida Freight: 144.27
and the prevailing party shall be entitled to reasonable attorney's fees and all costs incurred including any appeal. Thank you For Your Order
Prompt payment assures good standing future credit. Total Invoice: 1,683.17
We hereby certify that these goods were produced in compliance with all applicable requirements of Section 6, 7, and 12 of the Fair Labor Payment Received 0.00
Standards Act as amended, and regulations and orders of the U.S. Dept. of Labor issued under Section 14 thereof.
Balance: 1,683.17
INTEREST WILL BE ADDED AT LAWFUL RATES TO PAST DUE ACCOUNTS. Payable in U$ Funds On
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
358126
GOLDSTAR PRODUCTS INC Purchase Order No.
PO BOX 291630 Terms
DAVIE, FL 33329 Due Date 5/21/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/21/2012 49310 $1,683.17
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 125011 WARRANT ALLOWED
358126 IN SUM OF
GOLDSTAR PRODUCTS INC
PO BOX 291630
DAVIE, FL 33329
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
49310 01- 7200 -02 $1,683.17
I
i
f
Voucher Total $1,683.17
Cost distribution ledger classification if
claim paid under vehicle highway fund