216415 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 117785 Page 1 of 1
= ONE CIVIC SQUARE HP PRODUCTS CHECK AMOUNT: $1,513.07
CARMEL, INDIANA 46032 PO BOX 68310
INDIANAPOLIS IN 46268 CHECK NUMBER: 216415
CHECK DATE: 1/15/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 11563466 1, 513 . 07 OTHER MAINT SUPPLIES
Women-owned Business Enterprise(WBE)
Excellence in Distribution
Products CORPORATE OFFICE ISO 9001:2008
42 INVOICE
4220 Saguaro Trail
Indianapolis,IN 46268 Certificate Number 2006-005
Phone:317-298-9950 FAX: 317-293-0459
Date :1/9/2013
'I'I"I((�I���IIIII(II(roll(.I.(IIII�I((Irrllll(II���(illl�((III Ship To #: 1
000024"001"001UT0"3-D1GIT460 AB CITY OF CARMEL STREET DEPT
SOLD TO#:C002056 — 3400 W 131 ST ST
CITY OF CARMEL STREET DEPT CARMEL, IN 46074
3400 W 131 ST ST U S
CARMEL IN 46074-8267
Invoice No. Invoice Date Terms Customer Purchase Order No. Sales Representative
11563466 1/9/2013 Net 30 Amy Lunn 1-9-13 Barbara Roberts 0
I Order No. j Order Date j Ship Via Customer Reference Customer Service Contact
S01695478 1/9/2013 IN00 Extension# 1300
Ordered B/O Shipped UOM Item No. Description MFG Item# Unit Price Amount
6.00 6.00 CS 114353 KC 01890 Kleenex M- 01890 58.75000 352.50
Fold Towel Wht
16/150/cs
6.00 6.00 CS 119464 GP 198-80/01 Envision 19880/01 72.75000 436.50
2ply Tissue 80/550/cs
6.00 6.00 CS 128544 KC 91552 Luxury Foam 91552 80.76000 484.56
Skin Clnsr Cassette
1000ml 6/cs
6.00 6.00 CS 112000 HP Can Liner 24x32 .5 P-S4501-K 37.76000 226.56
Mil Black 500/cs (10/50)
500/case flatpack 21965
117/skid
1.00 1.00 EA 999907 Fuel Surcharge 5500000998 12.95000 12.95
Remit to and make checks payable to : Subtotal: 1,513.07
HP Products Sales tax: 0.00
PO Box 68310 Invoice total: 1,513.07
Indianapolis, IN 46268 Amount paid: 0.00
Total due: 1,513.07
Pagel
THANK YOU FOR YOUR BUSINESS!
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))
01/09/13 11563466 $1,513.07
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
HP Products
IN SUM OF $
P. O. Box 68310
Indianapolis, IN 46268
$1,513.07
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 1 11563466 1 42-389.001 $1,513.07 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
b. 1=rida ,,January 11, 2013
1.. V.
ctrEStreet,Comrnissloner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund