213640 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 366568 Page 1 of 1
ONE CIVIC SQUARE RICHARDS CYLINDER HEAD REPAIR 8,CHEX
ECK AMOUNT: $175.00
CARMEL, INDIANA 46032 6403 W THOMPSON ROAD
INDIANAPOLIS IN 46221 CHECK NUMBER: 213640
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 10937 175 . 00 TRANSPORTATION EXPENS
RICHAR®5 CYLINDER HEAD
R,EPA11R & EXCHANGE, INC. z:ALEC) URDER
6403 W. Thompson Rd.
Indianapolis, IN 46221 I NVOICE N o 10937
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(317) 856-9163 ORIGINA L PAWS 13 7.7 4
BILL TO: �. ;
L ry^
OCT 0 3 2012
INVOICE DATE PURCHASE ORDER NO. TERMS F.O.B.
fr'�.,. Indianapolis, IN
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Disclaimer of Warranties SUBTO-TEAL
T A X°�
1 Any warranties on parts said hereby are those made by the manufacturer. The seller TOTAL I'
Richards Repair, Inc., hereby expressly disclaims all warranties, either express or implied.
TOTAL DUE
2 Cylinder Heads carry a 90-day warranty, under condition of proper installation, maintenance
No-Warrant-On-Partial-jobs.
3 Purchaser agrees to reimburse and pay seller for all costs incurred as a result of purchaser's
failure to pay this account. These costs include attorney fees, court cost and other litigation
expenses necessary to collect account. 30-day accounts overdue will be charged 1 1/2%
surcharge.
I understand and agree to these terms.
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Signature
VOUCHER # 125832 WARRANT # ALLOWED
366568 IN SUM OF $
RICHARDS CYLINDER HEAD REPAIR
6403 W THOMPSON RD.
INDIANAPOLIS, IN 46221
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
i
10937 01-7500-02 $175.00
Voucher Total $175.00
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
366568
RICHARDS CYLINDER HEAD REPAIR & EXCH) Purchase Order No.
6403 W THOMPSON RD. Terms
INDIANAPOLIS, IN 46221 Due Date 10/4/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/4/2012 10937 $175.00
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