210898 07/17/2012 �\tif CITY OF CARMEL, INDIANA VENDOR: 364770 Page 1 of 1
ONE CIVIC SQUARE ICE QUBE INC
CARMEL, INDIANA 46032 141 WILSON AVENUE CHECK AMOUNT: $172.22
GREENSBURG PA 15601
CHECK NUMBER: 210898
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 36587 172 .22 MATERIALS & SUPPLIES
, .:. INVOICE
Ice Qube, Inc. Page:
AV,
141 Wilson Ave 000001
Greensburg, PA 15601
Phone:888-867-8234 or 724-837-7600
` Fax:724-837-3386 or 724837-6365
www.iceQube.com
Email:salesQiceqube.com
Sold to: Ship to:
Carmel WWTP Carmel WWTP
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Indianapolis IN 46280 Indianapolis IN 46280
ATTN: Larry
ORDER # SHIP # LOC. SHIP VIA FOB COLIPPD INVOICE #
60448 25860 01 Fedex Overnig t repaid/Add 36587
ORDER DATE SHIP DATE CUST # I PURCHASE ORDER # I JOB # JSLSJ DATE
6/26/2012 6/26/2012 5696 1 VERBAL LARRY SCHIMMEL I JIQ 1 6/26/2012
LINE ITEM NUMBER UOMI QTYS: ORDERED SHIPPED BACKORDERED
SE # DESCRIPTION PRICES: PER UNIT EXTENDED NET
Tracking# 526294782399
1 BLYR1011 EA 1 1 0
BH-7800 120/230V BLOWER 119.00 119.00 119.00
NYLON WHEELS & HOUSINGS
Sales Amount 119.00
Misc. Charges .00
Standard Terms are Net 30 Days. Freight 53 .22
Sales Tax .00
Terms are net 30 days.Amounts not paid within 30 days of invoice date are subject to an additional charge of 1-1I2% INVOICE $172.22
per month.The buyer shall be liable for any legal or collection fees and any other incidental expenses incurred as a
result of the buyer's default or breach of this agreement.Buyer assumes responsibilityAiabildy for payment of all state or TOTAL
municipal taxes applicable to use or resale of products purchased herein.All orders will be subject to a handling fee.
LIMITATION OF LIABILITY:Through the acceptance of the items listed above,you ackno,Medge and agree that
any claims for damages you may have arising from the sale to you of these items are limited solely to the costs of
the items and under no circumstances shall include claims for consequential or any other kinds of damages.Such
excluded damages include,but are not limited to,harm.to other equipment,lost profits,and interruption of business.
VOUCHER # 125258 WARRANT # ALLOWED
364770 IN SUM OF $
ICE QUBE INC
141 WILSON AVENUE
GREENSBURG, PA 15601
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
36587 01-7200-03 $172.22
Voucher Total $172.22
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
364770
ICE QUBE INC Purchase Order No.
141 WILSON AVENUE Terms
GREENSBURG, PA 15601 Due Date 7/9/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/9/2012 36587 $172.22
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