212702 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 359582 Page 1 of 1
0 ONE CIVIC SQUARE MULTITRODE CHECK AMOUNT: $2,126.00
CARMEL, INDIANA 46032 990 SOUTH ROGERS CIRCLE STE 3
BOCA RATON FL 33487 CHECK NUMBER: 212702
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 16898 2, 126 . 00 MATERIALS & SUPPLIES
mul I Invoice
990 South Rogers Circle, Suite 3 Date Invoice #
Boca Raton, FL 33487 08/24/12 IN00016898
Phone (561)994-8090 SO. No. S000013819
Fax (561) 994-6282
FEIN: 23-2624171 TAG:
PO#S 13216
BILL TO:
Carmel Wastewater Utilities
760 Third Avenue S.W. SHIP TO:
Suite 110 Carmel WWTP
Carmel, IN 46032 9609 Hazel Dell Parkway
USA Indianapolis, IN 46280
USA
Ref: City of Carmel
el WWTP/
Sold To: Terms SO. Date Ship Date Ship Via Mark Goods PO Number
ARMEL-BILL Net 30 Days 08/23/12 08/24/12 FEDEXG S13216
Qty. Qty. Qty. Item Number Description Unit Price Extended Price
Ord. Shp. B/O
2 2 0 IC3 Controller Indicator 110VAC 922.00 1,844.00
-->1"1220083,G 1220320<--
5 5 0 AKI Kit Mounting Probe(Standard) 50.00 250.00
SHIP Shipping&Handling 32.00
FED EX GROUND
1 BOX u 8 LESS
Tracking: 0739604 1503 6796
....................
Due Date Amount Due
Sep 23,2012 2,126.00
�omments: Tank you for your business. We Accept Total $2,126.00
VISA AMEX'. MASTERCARD
Il funds must be payable in U.S. dollars
Please call 561-994=8090 for details Amount due $2,126.00
Buyer agrees to reimburse Seller any and all collection fees,attorneys'fees,and court costs incurred by Seller in
collecting any amounts due under this Agreement.The parties hereto agree that venue for any court action brought by
either party shall lie in Palm Beach County,Florida.This Agreement shall be governed by and shall be construed in
accordance with the laws of the State of Florida.The parties agree to waive the right to trial by jury in any
proceeding arising out of or related to this Agreement.
VOUCHER # 125638 WARRANT # ALLOWED
359582 IN SUM OF $
MULTI TRODE
990 SOUTH ROGERS CIRCLE STE 3
BOCA RATON, FL 33487
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
IN00016898 01-7202-06 $2,126.00
1
Voucher Total $2,126.00
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
359582
MULTI TRODE Purchase Order No.
990 SOUTH ROGERS CIRCLE STE 3 Terms
BOCA RATON, FL 33487 Due Date 9/5/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/5/2012 I N00016898 $2,126.00
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
'?/j U 6;-'f/it,
Date Officer