214073 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 00350177 Page 1 of 1
ONE CIVIC SQUARE SEARS HARDWARE
CHECK AMOUNT: $299.99
CARMEL, INDIANA 46032 DEPT 53-000004369
PO BOX 689134 CHECK NUMBER: 214073
DES MOINES IA 50368-9134
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 T336971 299. 99 OTHER EXPENSES
Page 1 of
SEARS COMMERCIAL ONE
PO BOX 6282 Basis
SIOUX FALLS SD 57117-628
Invoice Number: T336971 CommercialOnW
Account Number: 5405530000$
an To: INVOICE Amount Due: 320 99
0000003588102281 KSTRSIR1 AM1 0 Payment Due Date: 11-04-12
Purchase Location: 000001600
INDIANAPOLIS IN
° Merch Ref# 20121005001600*226R6998
r CARMEL WATER AND SEWER ULIL
3450 W 131 ST STREET Please Pay From This Invoice.
® WESTFIELD IN 46074-8267 Ship To:
1,1,i1,ill,Mil,,.il,fi.Irllrl�I�II„I1,illrrlluii,li,ll111i
DAN LEWIS
2 S HONEY CREEK RD
_ .... GRE WOOD IN
Customer No. Ordered By Authorized By P rchase Order No. Purchase Date Sears Ship Order No.
BLANE 10-05-12
Stock No/SKU Description____ _ _ _Quantity_ _ L Unit Unit Price —Extension
04280086000 8000 BTU E,PORTABLE AC 1 .0000 299.99 299.99
® SUBTOTAL: 299.99
Total Tax: 21.00
Total: 320.99
= I
This Account Issued by Citibank,N.A.
® SEND BILLING ERROR NOTICES TO: SEND INQUIRIES TO: FOR QUESTIONS ABOUT YOUR ACCOUNT:
Sears Commercial One Sears Commercial One (800)599-9712 -CALL
PO Box 6282 PO Box 6282 (800)599-9711 -FAX
Sioux Falls, SD 57117-6282 Sioux Falls, SD 57117-6282
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
urif you need more information about 8transaction shown on the reverse side. Payments that are received
thereon, write umuDB separate sheet at the inquiry in the mail at the designated address before S:OOam ({}ST)
address listed On the reverse side aa soon aepossible. nn any Monday through Friday that ia not a holiday will be
VV8 must hear from you nO later than 3U days after vve credited 8eof the day of receipt. |f payment ia not made
first sent you the invoice urbilling statement on which as provided harn\n, crediting may be delayed upto5 days,
the error or problem appeared.
You agree not to send ue partial payments marked
You must contact us in writing in order to preserve your "paid in full","without recourse", or ginni/mr language
rights, In your letter, give us at least the following information: unless such payments are marked for special handling
°Your name and account number and sent tmthe inquiry address on the reverse side.
°The dollar amount of the suspected error This Account io Issued by Citibank, N.A.
° Describe the error and explain, if you can, why
you believe there ivan error. |f you need more
information, describe the item you are unsure about.
-
-
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
350177
SEARS HARDWARE Purchase Order No.
P O BOX 689134 Terms
DES MOINES, IA 50368-9134 Due Date 10/18/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/18/201; T336971 $299.99
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
/a 1 i R 11 Cl- /(-
Date Officer
VOUCHER # 125958 WARRANT # ALLOWED
350177 IN SUM OF $
SEARS HARDWARE
P O BOX 689134
DES MOINES, IA 50368-9134
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
T336971 01-7202-06 $299.99
Voucher Total $299.99
Cost distribution ledger classification if
claim paid under vehicle highway fund