211207 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 365558 Page 1 of 1
ONE CIVIC SQUARE B W ROGERS CO CHECK AMOUNT: $749.22
CARMEL, INDIANA 46032 PO BOX 569
•, .p� AKRON OH 443091030 CHECK NUMBER: 211207
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 230777001 749 . 22 OTHER EXPENSES
INVOICE
MAIL REMITTANCE TO: ENTERING OFFICE INVOICE NUMBER TRAN
'1 B W ROGERS CO CODE
B fS 230777-001 DI
MACHINE DRIVE DIV-DISTR
' ° ' 2513 CRESCENTVILLE RD INVOICE DATE PAGE
P.O. Box 669,Akron, Ohio 44309 CINCINNATI OH 45241 05/15/12 1
For Terms and Conditions visit:www.bwrogers.com
Any different or additional terms that maybe embodied in your purchase order are hereby objected to. Ilyour order is man
acceptance of our proposal,this will operate as an acceptance of your order only in the event you agree to the terms hereof.
The terms and conditions contained above and attached shall apply.
QUANTITY
LINE PART NUMBER UNIT OF MEASURE UNIT PRICE EXTENDED
NO TOTAL BACK THIS DESCRIPTION PRODUCT DISCOUNT% AMOUNT
ORDERED ORDERED SHIPMENT
ORDERED BY: JEFF COOPER
PHONE#: 317-571-2462
TRACK#: IZ4703790342951874
CARRIER:UPS
SERVICE:GROUND
10 1 1 FP5-E7 VFD REPAIR PU#4 724.0000 724.00
NON WARRANTY RE R95 EA
INBOUND FRT IS: .00
FOLD
CUST.NO. ORDER DATE TERR PC ORD Written By DATE SHIPPED WHSE AMOUNT 724.00
C4037 05/11/12 8C 06 S FGH 05/14/12 06
FRGHT/INS/HNDL 25.22
Carrier: UPS FOB: SP,FNA,PREPAID ORIG EMAIL INV
SALES TAX
Tracking:
Terms of Payment: NET 30 DAYS CUST FAX#:317-571-2462 INVOICE TOTAL 749.22
Please Pay This Amount
ORDER ISSUED IN: CINCINNATI
PHONE: 513-793-7077
Customer PO No. S13092 Mark No.
s CITY OF CARMEL UTILITIES s CITY OF CARMEL UTILITIES
O ATTN:A/P H WASTEWATER
D 760 THIRD AVE SW r 9609 HAZEL DELL PKWY
T CARMEL IN 46032 T INDIANAPOLIS IN 46280
0 0
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
365558
B W ROGERS CO Purchase Order No.
PO BOX 569 Terms
AKRON, OH 44309 Due Date 7/24/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/24/2012 230777001 $749.22
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
7/2,-7/v
Date Officer
VOUCHER # 125385 WARRANT # ALLOWED
365558 IN SUM OF $
B W ROGERS CO
PO BOX 569
AKRON, OH 44309
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
230777001 01-7362-06 $749.22
Voucher Total $749.22
Cost distribution ledger classification if
claim paid under vehicle highway fund