214325 11/07/2012 CITY OF CARMEL, INDIANA VENDOR. 359478 Page 1 of 1
ONE CIVIC SQUARE HILLYARD/INDIANA CHECK AMOUNT $290.08
CARMEL, INDIANA 46032 P 0 BOX 872361
KANSAS CITY MO 64187-2361 CHECK NUMBER. 214325
CHECK DATE. 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 600433075 290 08 OTHER EXPENSES
PLEASE DETACH AT THE PERFORATION ABOVE AND RETURN THE STUB
Invoke D6160s:
ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT
oolo PG53971 4 CS 5441 217 64
TOWEL BOUNTY 30 RLS
002o HIL0103954 12 EA 287 3444
GERMICIDAL FOAMING CLEANER 20 OZ
003o HIL0106954 1 EA 2300 2300
DISPENSER METERED AEROSOL GRAY
0040 PAP42500 1 EA
DISP HANDS FREE BATTERY BLACK TRANS
Subtotal 275 08
Shipping 1500
Tax Amount 000
Gross Price 29008
Invoice Number 600433075 Date 10/15/2012 Purchase Order- BLAINE MALLABER
Plant. 1350 ouommo
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Invoice
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THE CLEmwNG88Owx^ Kansas City, Mm 64187'2361 CUSTOMER COPY THANK YOU!
THE SELLER REPRESENTS IT HAS FULLY COMPLIED WITH THE PROVISIONS IO THE FAIR LABOR STANDARDS ACT STANDARDS ACT OF'1938,^n AMENDED,/°THE MANUFACTURE OF GOODS COVERED 9'(,°m=mC".
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
359478
HILLYARD/INDIANA Purchase Order No
PO BOX 872361 Terms
KANSAS CITY, MO 64187-2361 Due Date 10/25/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/25/201; 600433075 $29008
1 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
VOUCHER # 125987 WARRANT # ALLOWED
359478 IN SUM OF $
HILLYARD/INDIANA
PO BOX 872361
KANSAS CITY, MO 64187-2361
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
600433075 01-7202-05 $290.08
Voucher Total $29008
Cost distribution ledger classification if
claim paid under vehicle highway fund