211655 08/14/2012 a- CITY OF CARMEL, INDIANA VENDOR: 00352276 Page 1 of 1
ONE CIVIC SQUARE BREAKERS UNLIMITED
= CHECK AMOUNT: $832.60
CARMEL, INDIANA 46032 15241 STONY CREEK WAY
NOBLESVILLE IN 46060 CHECK NUMBER: 211655
CHECK DATE: 8/1412012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1105981-01 832 . 60 MATERIALS & SUPPLIES
BREAKERS 15241 Stony Creek Way
Noblesville, IN 46060
UNLIMITED Office 317 776.8817
Fax 317 ( 773.9867
One Call. In Stock. Right;`Vow. breakersunlimited.com
CUSTOMER CODE SHIP/TR/ INVOICE NUMBER
CAR700 1105981-01
317 571 2634 —
O BILL CARMEL WASTEWATER UTILITIES SHIP CARMEL WWTP O
TO: TO:
+, 760 THIRD AVE SW SUITE 110 9609 HAZEL DELL PRKWY 0
V CARMEL IN 46032 INDIANAPOLIS IN 46280 0 C
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O CUSTOMER P.O. NO. S 1317 7
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YSHIP I TR I INVOICE NUMBER SLSMN. ORDER DATE TAKER CUSTOMER P.O.NUMBER DATE Cn
1105981-01 100 07/25/12 101 S13177 07/25/12
0 INSTRUCTIONS FRT. PAGE NO.
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vj K 4 4 BU9998-SL7 EA 208 . 15 832. 60 0 r
V LL SQD 3P SZ 3, 100 TYPE S '<
****************************
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O THANK YOU FOR YOUR PURCHASE S
YOUR UPS TRACKING NUMBER
i E FOR INVOICE# 1105981-0001 IS: _
lZ8138790351664243
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*** THIS IS YOUR INVOICE *** SUBTOTAL 832. 60 Q•
MISC.CHARGE CD
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FREIGHT IN FREIGHT OUT TELE.CHARGE 0
0. 0 0 0. 00 FREIGHT TOTAL 0. 00
FED./OTHER TAX
NET TERMS: INV 30 DUE: 08/24/12 STATE TAX
*** ORDER COMPLETED *** PAYMENT RECD. 0.00
Please Remit Payment To: Breakers Unlimited TOTAL AMT DUE
15241 .Stony Creek Way 832. 60
Noblesville, IN 46060 ----
VOUCHER # 125453 WARRANT # - ALLOWED
352276 IN SUM OF $
BREAKERS UNLIMITED
15241 Stony Creek Way
Noblesville, IN 46060
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
!�A
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1105981-01 01-7202-06 $832.60
Voucher Total $832.60
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
352276
BREAKERS UNLIMITED Purchase Order No.
15241 Stony Creek Way Terms
Noblesville, IN 46060 Due Date 8/2/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/2/2012 1105981-01 $832.60
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