211186 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 358688 Page 1 of 1
1 ONE CIVIC SQUARE AGRO CHEM CHECK AMOUNT: $35.77
�f®? CARMEL, INDIANA 46032 2045 S WABASH STREET
WABASH IN 46992 CHECK NUMBER: 211186
CHECK DATE: 7131/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 IN00524906 35 . 77 REPAIR PARTS
AGRO CHEM, INC. Invoice Date Invoice#
AGRO CH M 2045 S WABASH STREET 7/12/2012 IN00524906
® WABASH, IN 46992
Phone: 800-686-5680
Fax: 888-281-4321
www.agrochem.com
Bill To Ship To
CITY OF CARMEL INDIANA CITY OF CARMEL INDIANA
ONE CIVIC SQUARE 3400 WEST 131 STREET
CARMEL,IN 46032 CARMEL,IN 46032
STATEMENTS SENT BI-MONTHLY-PLEASE PAY FROM INVOICE
P.O. Number Rep Ship Via Terms Due Date
JEFF STEWART 5 7/12/2012 UPS NET 30 DAYS 8/11/2012
Ordered Shipped B/O Item Code Description Price Each Amount
1 1 0 343080 10'THREADED CAP 26.40 26.40
I 1 0 UPS SHIPPING 9.37 9.37
Total $35.77
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/12/12 IN00524906 $35.77
1 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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Agro Chem Inc
IN SUM OF $
2045 S. Wabash Street
Wabash, IN 46992
$35.77
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
r
2201 I IN00524906 I 42-370.001 $35.77 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday,;July 26, 2012
Street Commissioner
Ctroar r'nm^ i�cln^a�
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund