210859 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 360946 Page 1 of 1
0 )• ONE CIVIC SQUARE GODWIN COMPANY INC CHECK AMOUNT: $184.20
CARMEL, INDIANA 46032 1175 W 16TH STREET
`o INDIANAPOLIS IN 46202 CHECK NUMBER: 210859
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 22016 184 . 20 TRANSPORTATION EXPENS
Godwin Company, Inc. 0 MV0 HC
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1175W. 16th Street Invoice Number: 22016
Indianapolis, IN 46202
US Invoice Date: Jul 2, 2012
Page:
Voice: 317 637-3325
Fax: 317 263-9625
Website:www.godwincompany.com
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CARMEL WASTEWATER UTILITIES CARMEL WASTEWATER UTILITIES
ATTN: ACCOUNTS PAYABLE 9609 HAZELDEL PKWY
760 THIRD AVENUE SW, SUITE 110 CARMEL, IN 46032
CARMEL, IN 46032 us
US
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Pay!nent- erms"..,,
3097 CARMEL WASTEWATER Net 10 Days
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Sales Rep
Han.d Deliver 6/29/12 7/12/1q2
It. Description.:;
2.10 LABOR LABOR HOUR ON ROAD JOB#46496 - 72.00 151.20
CLUB CAR CARRY ALL/PG 9834/6876 53
1.00 TC TRUCK CHARGE 33.00 33.00
I Any parts returned must be returned within 5 Subtotal 184.20
days and be accompanied by the original Sales Tax
invoice.Returns subject to 25% handling fee.
Special Order Parts and Electrical Parts not Freight
returnable. Total Invoice Amount 184.20,
1.5%FINANCE CHARGE per month on Past Due
Accounts over 30 days.Annual Percentage Rate Payment/credit Applied
is 18%. TOTAL l P 7
-.
484 20
Customer Signature
White-Customer Copy Yellow-Cust6mer Packing Slip Pink-Service Copy Gold-Parts/Rentals Copy
VOUCHER # 125292 WARRANT # ALLOWED
360946 IN SUM OF $
GODWIN COMPANY INC
1175 W 16TH STREET
INDIANAPOLIS, IN 46202
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
22016 01-7502-06 $184.20
Voucher Total $184.20
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
360946
GODWIN COMPANY INC Purchase Order No.
1175 W 16TH STREET Terms
INDIANAPOLIS, IN 46202 Due Date 7/12/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/12/2012 22016 $184.20
I hereby certify that the attached invoice(s), or bill(s) is (are)true and
correct and I have audited same in accordance with I/C, 5-11-10-1.6
Date Officer