216058 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 365285 Page 1 of 1
ONE CIVIC SQUARE H D SUPPLY UTILITIES LTD CHECK AMOUNT: $501.00
CARMEL, INDIANA 46032 PO Box 485
4 0�Via? ORLANDO FL 32802 CHECK NUMBER: 216058
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350080 2159343-01 501 . 00 STREET LIGHT REPAIRS
r.
PLEASE REMIT PAYMENT TO
HD Supply Utilities LTD. INVOICE
P.O. Box 4851
Orlando, FL 32802
Phone: 940.270-7220 UPC INVOICE DATE INVOICE NO. ""
Fax: 866-580-8629 000000 12/19/12 2159343-01
P.O. DATE P:O:NUMBER PAGE NO..
12/07/12 mmat 1 of 1
cusT u: 6034663 IIIIII�IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIII�II�IIII�IIIIIIIII
BILL TO: CITY OF CARMEL SHIP To: CITY OF CARMEL
CARMEL STREET DEPT. 3400 W 131ST STREET
3400 W 131ST STREET CARMEL, IN 46074
CARMEL, IN 46074
INSTRUCTIONS SHIP POINT VIA SHIPPED TERMS
** Drop Ship jBest Way 12/19/12 INet 30
PRODUCT AND DESCRIPTION ORDERED BO SHIPPED UM PRICE UM DISCOUNT NET AMOUNT
3 WLLF200SCABK 00000 3 0 3 each 167.00 each 0.00 501.00
LEVELING FITTER WEST LIBERTY ARM
1 Lines Total Qty Shipped Total 3 Total 501.00
Invoice Total 501.00
Last Page
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
HD Supply Utilities LTD
IN SUM OF $
P. O. Box 4851
Orlando, FL 32802
$501.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 1 2159343-01 1 43-500.801 $501.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
'Friday/'January 04, 2013
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/19/12 2159343-01 $501.00
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
, 20
Clerk-Treasurer