217196 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 366858 Page 1 of 1
ONE CIVIC SQUARE INDIAN SPRINGS MFG CO CHECK AMOUNT: $264.44
CARMEL, INDIANA 46032 PD BOX 469
+ 2095 W GENESEE RD CHECK NUMBER: 217196
BALDWINSVILLE NY 13027
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 5922 264 . 44 OTHER EXPENSES
Indian Springs Mfg. Co., Inc.
P.O. Box 469
2095 W Genesee Rd
Baldwinsville, NY 13027
iN®fAN1 I United States of America
M AN OF A C T U R i NC Ph: 315-635-6101
Fax: 315-635-7473
Invoice
Number: 5922 Date: 29-Jan-13
To
Ship To
City Carmel City of Carmel
Water r Utilities Water Utilities
3450 West 131st St
Carmel, IN 46074 3450 West 131st St United States of America Carmel, IN 46074 United States of America
Net 30 Days ..,,... .,,... P��«,..,..0 .
y 28-Feb-13 Best Way —
Quantity De o � Amount
1 Kit A Instructional DVD $125.00 $125.00
ea
Packing List: 2968 Shipped On: 29-Jan-13
Part:ALAD
PO:JA011113B Ln:001 SO: 7204
1 Kit B instructional DVD $125.00 $125.00
ea
Packing List: 2968 Shipped On: 29-Jan-13
Part: BLAD
PO: JA011113B Ln:002 SO: 7204
Best Way
$14.44
Invoice Total: $264.44
Amount Paid: $0.00
Amount Due: $264.44
U.S. Dollars
Page 1 of 1
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
366858
INDIAN SPRINGS MFG Purchase Order No.
PO BOX 469 Terms
2095 W GENSEE RD Due Date 2/5/2013
BALDWINSVILLE, NY 13027
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/5/2013 5922 $264.44
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
VOUCHER.# 123461 WARRANT # ALLOWED
366858 IN SUM OF $
INDIAN SPRINGS MFG
PO BOX 469
2095 W GENSEE RD
BALDWINSVILLE, NY 13027
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
5922 01-6200-04 $264.44
Voucher Total $264.44
Cost distribution ledger classification if
claim paid under vehicle highway fund