214755 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 365006 Page 1 of 1
ONE CIVIC SQUARE NALCO CROSSBOW WATER CHECK AMOUNT: $190.00
CARMEL, INDIANA 46032 NETWORK PLACE 24658
�y,TOM`o CHICAGO IL 60673 CHECK NUMBER: 214755
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2093420 190 . 00 MATERIALS & SUPPLIES
C RCtSS C:)VV-
�°` W ate r Invoice
Nalco Crossbow Water
Network Place 24658
Chicago,It, 60673
USA Invoice No. 2093420
Customer No. 0310060A
Bill To F Ship To
CITY OF CARMEL WASTEWATER UTILITIES CITY OF CARMEL WASTEWATER UTILITIES
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Indianapolis,IN 46280 Indianapolis,IN 46280
Contact: Teresa Lewis Contact: Teresa Lewis
Telephone: 317-571-2634 210 Telephone: 317-571-2634 210
Invoice Date Order Date SO Number Ordered By Customer PO Number Payment Method
10/31/12 10/30/12 Net 30
Warehouse Ship Via F.O.B. Salesperson Resale Number
INDY Crossbow Truck Chris Coppock
Order Ship Unit Extended
Tax Item Number/Description Q uantit y
Price Price
2 2 Y DMD1 U of M: EACH 95.0000 190.00
DI EXPRESS
IT SERVICE EXCHANGER
01 D80 FRP MMED
D000527 &D000711
Print Date 10/31/12 Due Date 11/30/12 Subtotal°: 190.00
Print Time 10:10:26 AM Freight: 0.00
- Page No:Y 1
Printed By:Laura Robertson Total Paid 0.00
Balance Due 190.00 Invoice Total 190.00
VOUCHER # 126087 WARRANT # ALLOWED
365006 IN SUM OF $
NALCO CROSSBOW WATER
NETWORK PLACE 24658
CHICAGO, IL 60673
Carmel Wastewater Utility
i
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
!
2093420 01-7202-05 $190.00 +
(
i
I
Voucher Total $190.00
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
365006
NALCO CROSSBOW WATER Purchase Order No.
NETWORK PLACE 24658 Terms
CHICAGO, IL 60673 Due Date 11/9/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/9/2012 2093420 $190.00
1 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