214455 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 358086 Page 1 of 1
ONE CIVIC SQUARE VULCAN INDUSTRIES INC CHECK AMOUNT: $569.00
CARMEL, INDIANA 46032 PO BOX 390
212 S KIRLIN STREET CHECK NUMBER: 214455
MISSOURI VALLEY IA 51555
CHECK DATE: 1117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 12369-11561 569 . 00 MATERIALS & SUPPLIES
Oc t. 22, 2012 10: 58AM No. 0377 P. 2/2
VULCAN INDUSTRIES, INC. Invoice
212 S. KIRLIN 1 P.O. BOX 390
MISSOURI VALLEY, IA 51555 Date Invoice#
712-642-2755 10/19/2012 12369-11561
712-642-4256 fax
Bill To Ship To
Carmel Wastewater Utilities Carmel WWTP
760 Third Avenue SW 9609 Hazel Dell Parkway
Suite 110 Indianapolis, IN 46280
Carmel, IN 46032
Customer Phone Customer Fax
317-571-2634 317-571-2636
P.O.Number Project Name Date Shipped Shipped Via F.O.B. Terms Rep
S13326 Carmel, IN 1 011 9/201 2 UPS FFA Net 30
Quantity Description Price Each Amount
1 Lot Spare Parts per Order 569.00 569.00
ORDER COMPLETE
**NTA:
NO TAX ADDED. ANY APPLICABLE TAX IS TO BE PAID
BY CUSTOMER DIRECT TO THE STATE OF INDIANA.
Total $569.00
VOUCHER # 126003 WARRANT # ALLOWED
358086 IN SUM OF $
VULCAN INDUSTRIES INC
PO BOX 390
212 S KIRLIN STREET
MISSOURI VALLEY, IA 51555
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
12369-11561 01-7202-06 $569.00
Voucher Total $569.00
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
358086
VULCAN INDUSTRIES INC Purchase Order No.
PO BOX 390 Terms
212 S KIRLIN STREET Due Date 10/29/2012
MISSOURI VALLEY, IA 51555
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/29/201: 12369-11561 $569.00
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
Date Officer