214717 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 00351074 Page 1 of 1
ONE CIVIC SQUARE KIMBALL-MIDWEST CHECK AMOUNT: $267.49
CARMEL, INDIANA 46032 DEPT L-2780
COLUMBUS OH 43260-2780 CHECK NUMBER: 214717
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 2693576 267 .49 OTHER EXPENSES
I INVOICE INVOICE NO. I DAYS NT FEE'
INVOICE 1 DAYS;
PLEASE PAY FROM THIS INVOICE 2693576
ORIGINAL ORDER NO.Spartafizing ira hater u1s,blQnu�erxeie!sfntc 193 0 5 0 2 2 3 2.E •
REMIT TO: KIMBALL MIDWEST ACCOUNT NO. . ,
DEPT.L-2780 •• • ■
COLUMBUS,OHIO 43260-2780 (614-219-6100) 65060
www.kimballmidwest.com
SOLD TO: SHIP TO:
CARMEL WATER DISTRIBUTION CARMEL WATER DISTRIBUTION
3450 WEST 131ST ST 3450 W 131ST ST
CARMEL IN 46032 WESTFIELD IN 46074
JIM HAAG
DATE ISALES REPRESENTATIVE1 PURCHASE ORDER NO. SHIPPED VIA& DATE
11/05/12 COHENr ROBER JIM U UPS GROUND 11/05/12
ORDERED SHIPPED BALANCE DESCRIPTION UNIT PRICE AMOUNT
DUE
1 1. 834613T KIM-WEAR MECHANICS GL. 18 .49
29PC.. SUPER PRIK-DRILL:
1 1 82992 #2 DOUBLE-DUTY EXTRA .00
7 1 $2,993 . ; #3 D0UBLK.0T)TY;*K.XTFA _ .
UPS TRACKING # : 124781.7303390090 1 WGT:4
To ..help ias. correctl y`proces_s- yo r. payment _:pease. .. _'
include invoice number_ on your remittance advice
w.
:thank yo-1 for. y r.:business. ;Payment :is. due 12/0
D1ea5e. .zri it .by 11/28 _.. : _... _... . . ... .
t'o recei-ve invoices via email send a request i-nc- _uding you
account, invoice.@kimba..1.:.1J idwest .'cam;
umber;.t:. ,...
You acknowledge and agree that,by placing this order,all information provided to you by Kimball Midwest herein is confidential and is the property of Midwest
Motor Supply Co.,Inc.d/b/a Kimball Midwest.You further agree that this Information Is for your internal use only and will not be copied,reproduced,distributed
or disclosed by you and/or your organization without the prior written consent from Kimball Midwest.
CARRIERS RECEIPT IN GOOD ORDER CON- ORDERED TAX% TAX AMT. SHIPPING INVOICE TOTAL
SI ITUTES DELIVERY AND CLAIMS FOR LOSS
OR DAMAGE IN TRANSIT MUST BE Fl.FD BY
CUSTOMER
WILL POSITIVELY L OTnBEAOCCEPTED CONSENT 267 . 49 2 67 .4 9
DEBTOR IS LIABLE FOR USUAL ANO Cl19TOM-
ARY COLLECTION CHARGES,
ALL CHECKS MUST BE MADE PAYABLE ONLY
TO"KIMBALL MIDWEST We Appreciate Your Business PLEASE REMIT THIS AMOUNT
VOUCHER # 122726 WARRANT # ALLOWED
3551074 IN SUM OF $
I
KIMBALL MIDWEST
Dept L-2780 I
Columbus, OH 43260-2780 ;
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
I
PO# INV# ACCT# AMOUNT Audit Trail Code
c
2693576 01-6500-05 $267.49
,I
Voucher Total $267.49
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
3551074
KIMBALL MIDWEST Purchase Order No.
Dept L-2780 Terms
Columbus, OH 43260-2780 Due Date 11/12/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/12/201: 2693576 $267.49
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