The URL can be used to link to this page

Home My WebLink About217645 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 319510 Page 1 of 1 `1 ONE CIVIC SQUARE GRAINGER INC CHECK AMOUNT: $602.45 CARMEL, INDIANA 46032 DEPT 804572097 PALATINE IL 60038-0001 CHECK NUMBER: 217645 CHECK DATE: 2/26/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 90559567942 61 . 99 OTHER EXPENSES 1096 4239039 9058040511 2 . 96 GENERAL PROGRAM SUPPL 1205 4238900 9064012371 39 . 60 OTHER MAINT SUPPLIES 1205 4237000 9064672752 129 . 34 REPAIR PARTS 651 5023990 9066161895 368 . 56 OTHER EXPENSES PAGE 1 OF 1 /till ® GRAINGER ACCOUNT NUMBER 813555497 INVOICE NUMBER 9066161895 5959 W. HOWARD STREET INVOICE DATE 02/13/2013 =- NILES, IL 60714-4014 DUE DATE 03/15/2013 www.grainger.com AMOUNT DUE 368.56 = Ship to information is listed below PO NUMBER: BLAINE — in the description section CALLER: BLAINE MALLABER CUSTOMER PHONE: (317) 571-2634 BILL TO ORDER/DELIVERY#:6220127564 °- MDG2013 00031377 1 MB 0405 INCO TERMS: FOB ORIGIN lll'll'lllllllll'llll�lllll'1111111'll'IIIIIII�IIII�11Llllll �ll CARMEL WASTEWATER UTILITY ®_ 760 3RD AVE SW STE 110 STE110 CARMEL, IN 46032-2070 t v THANK YOU! FEI NUMBER 36-1150280 = FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 1-877-202-2594 _ •• ITEM# DESCRIPTION 'QUANTITY TOTAL The following items were shipped to: CARMEL WASTEWATER 9609 HAZEL DELL PKWY INDIANAPOLIS IN 46280-2935 I`* 4EKT1 SOLENOID VALVE,1/2 IN,ORIFICE 5/8 IN 2 184.28 368.56 MANUFACTURER# 8210GO94N NUMBER OF PKGS:0 WEIGHT 4.40 INVOICE SUB TOTAL 368.56 DATE SHIPPED.02/13/2013 CARRIER.UPS GROUND TRACKING NO.1Z6533410389004012 These items are sold for domestic consumption in the United States If exported,purchaser assumes full responsibility for comphanc?with US export controls GRAINGER STANDARD TERMS AND CONDITIONS A. SALES PUHi�'i C Warranty MOM Return. t. Miolp"dto Only. Has mmy=Mon"," on N,lw a A V!�%l ;I�s r�Anir,V ei;,l1W Io �,,�ih C:wwr dl�nl,�t�i;wo �Ii;;h!A2 l',-t 01"C Ct lriC�"OUr J4 pl,� url,r- t�Jalu �ro: l)inf��,!',li jatoi,,irom all,;jswlCd;�pr��T 0, 0why to My L OMW"9 AdInkno df 54*0 T 01 is Snamn MCA 1 NINIAV9 Wdlomwe I buns. tim o-.'Yo t,v r,gvId)Cjn,�,C[,Ol, T,C:qfol.,tn,ot;tu, o71f,,t•3f ih,O r l C,r I so n:r I on, Vt�, li,. 1. can W&MM am now M" PWO MQ M MIMMM 0 1 wts i C'C'._-c,)neaood,tY pinoc i, -'e pl:cyo at�rwolou+o cv ioukpt 0,tanufructurefs 143firtirly. oniriut ide JCCC,ei G,Ch o,0,01 -)Iin,at I=ywqu a!0c ow m 51 Eon For numaN W a ywhe"YM on S WMN Am MM Inc ,Ci G j C 1 ,i Cr,:, A nNo MOM 3. ohs lax. 6. Product Gawbann and SAMORY. up my.WNWIn K Inman v a 4549!A an to pm x A wvdq a Owl mks 0 a p MM"WA Comm vMm 0 max nN he aakk en we in A Yaq 0 onger Cos aa jvmoe�, C 1AMM an"Mm W(cs cumollanf;d ill ultab"llot 0!the�`r f:!s I Ip!tc anY 1,uas(,r cog,Inion'J'r lc-el I - f3f costoi,,,� nqh Cash,Nhe,c"; )'Onev V,�, :4 and��,ntdicoi, �q,-,� In�V I'II'lil'o e�.rll�jllg'l Lrelt! PLI�K��d� �o e ��CC d-v-,COCC,tlie dat,_ Ail�,iolli Al"'i, :Kilr' t�,.pialmu�, aw;�di,,t:oo &:�!o tot no""r�SoKcrinK OMW Q OMW M Muni 41 It WMS N so"na a M Imp&OW M"bw am nun IN,MUM WMAW, now to UNA%W MNM4 am WM00O ol Cme C,:-inyma-s-l'i US.ve,C�Cih' cl.n%eniaforl fe,for Q Ih�Cght io'hara:, I lar",ravine Ii!:..0 111,,Cloi ol on,,ol,fl on.:;ial; O. PHNUCTINiORPONON yjah t ratanonbaw tI A:;C�io,idon an,,,�dsh 1,nu or'lors :;,;;�,�:.,-,�?��x,),�,,�i,�''!I,!�! ,.,.��,,,-,,:;,,,.,;,Lli��,"��-�, r;7),,KIM As!�bw , m6el! I-ch _ r"4'- Ali:;oran1q1 fofziogers C,Prat!lutls,oF 0':1, 2- Product piehili! uj C."nnoi C :i ter. Tie! It, i'ttil�',ocli['31/7)1toll-,,�"unp;wn",i;Owd', Cr.sr Oqkw,IlId o, C' t�;tC?T y3nv'j'� oPi"PIC, C; ed'lto Cneii'M Cleo vi)iol,pla,;I i, 3. Occupatkoial Satiety and 4aaftij Aflnoia afiono t"OSHA I Hai3r0ous Substance an.,;en", C I"di l,lcf t1'idrd t!`Gtply O"ata tit,. 'p laQ:',�-.o;,�;'.A urt�,, ',I J. C IPYd�NG-:I Itlpv� N,) A'- PTIULK OR OAK WFV laprf us Amnon AWWRIN& NIC�iw 4 PON and NupWin 0 RON roe quA. A.Ce. lo"samo�lol IN;q why mampn mv�AWS LW a 1 W�Mwdbj Y 'm W nwo"1,0 04V gu"vw,we "Cal"W'!Cled I h:�:-,;odj'�;S_,fad fld�',a aiepltr;to F!,OSr1j1`1it11 HA.��,IU tEWEETED NE CKOF BAL AWE WOHIN M IQ n"My M 1, Rewwiv-us M t'o in M XI wy, MR Cy KIMMIG AM %JAWE Wh.1 BE COUIALT,MG GBARA SHUL HOE NO RAPER I Important alke w FWam Customers M:UwAry of DNA. ✓ou a Wcua• mW a MA UnwaylvoD man vw Mwwon of the On AWsmy Art N4) a� J,/ ones!Aqih di�-,, AmMin No 25 no pum n on h qpnx 0, m Mal V, 8 FNNi PRICY At ths none'r enn,�,t, lno iotoi as o onq MW Wn N B nun "IN n"MA R)duty&,4y"Wo 0 IF WiV bww JAMA a Shwo: to ai woln�l:furtoktoxof �i,J�,-us M.Wnh�ap",a MW of am al Fe""It"iru �er rustD(O(l,� IDI �md WIIK�Intf Clwrg��.Mil 1Y On cfacal-� �OM�i'3 dallad are""1011 C'st, pufr.ldrlt�n RY any to, nitn'!ha, �,IY forstandet'ircurol fi-livory Oj� SON Bowe In ax"Mmu wdwqm aq bak wivan am q W mawtv U,WH 00 owO, C, mlI,�I vvillh_,alpn�c wag up 0 pwwos are P I"Maq saww"am no%nw 4W W IM Wo W030 mmy I AN"Mrs, (Oode,lwt�ikSereceos"), fi�!,,Otit��,f;oto unitatoO -lpt,!Ited S31-ne clOy fp)ft ;ti1_ih11ij�UvC)o1eI`s ohn TN"nanow man"Wimp%aw uno muh Nam.moms"aw"M W. Us a a M.W.M.Win.mom kif WRA"� ',h� (�uh �- *l i 11 Fj��it,Shiou�o--Funos� UPIC,rqCo,,�, ouunry of Crun nw�m!!,)It I;h•_',r id,1,14td 10 pultowe� To"",dtrf'Hilloo AH dA 1,305 nnpo,�Kce K�;t!l alo, rrjo,,Nine;�ts u,�do, Rr lo,fit,a"ILOrn IT WOMPY POLM E. GBIEULTUMS (JsAlfffi tI)AHRAWY. t force WrJurp (JR104110RAHTFA %mr,sull wo x INA,Q Tw An In M up"04 A wNwrom own I ON a M W"M Y"', flK ot3tN.�L �GUOIMFtfl rAAIolUI,;GiLj1F GRAMir,EH,WAPRANT!:; NOR%1AIL USI�RNA P�PIODO"ONE Q ",�H ")I ou,,�ron)".fIL1;CCc, e 0? H51,i,i,Nd�0,I_I';',CH,_1 h-.n,(PIP-AGEFL OFii,�RWICF S70FK) PR(MOID 1HA1 po�w;l,vlhoiez;,t,�-j'ucainit, nahfl!i"to pr,,ul",o'tq i'i�7 ".,,N,IUT FIV� I��!�lirj' fifE 1j)V.ARP.A11,,,T)' (-',RAINGER rAAY,M F�`, 0,3,�U;,!;;UpfAo� �e ov ja'�r(;ohj._, Vo,'� e7�Jji"Kt��r COCI�jjj�f?j 1 C, pl`pAh� �IcI RtPIIC", _aI no. CrFl",R) ffili'AYCJQ_1?%F PAID I,'+ beyond nl,,C',,t-(3,Ke f,i ij! I ,",Crl.,: o; rhCDUi;t -PROVE PRNMER WANuH OR AWHORIl1 StR LICE 1_0,700N,A`� A Ginaln",MlAmmm 0%wo', QUM S RANK URNNAR-S RPM, RF,ll ACN)ILN T nR RE O Jr (,u'A,2wpr -) 1,�31.1 II!aK illH7H H i,,Ihil [:i) 0,OfE, 3 Cancel anot. l,��r,"ERCHANIABI C cj air �OR",PAR!l(ULAH Plj`illi;;r::OR ot)ff)NI-O Ati;)YjIa 01 MTKE AWADIT WHINCIM ROKWACK0 C NOW HIM 0 GMYT MMS W *WPATRS M THE 14"110 AS CORUW60 01 HE WGWOON-UNS mom "Nev'rox.nannih COMMOSWA unusd Cnda;oaued of"Iin,'n 3. ........... PAGE 1 OF 1 ® O !ilia GRAINGER ACCOUNT NUMBER 813555497 INVOICE NUMBER 9059567942 =_ 8211 BAVARIA ROAD INVOICE DATE 02/05/2013 MACEDONIA, OH 44056-2259 DUE DATE 03/07/2013 www.grainger.com AMOUNT DUE 61.99 Ship to information is listed below PO NUMBER: 513449 in the description section PO RELEASE: 513449 DEPARTMENT: 513449 ---_ BILL TO PROJECT/JOB: 513449 MDG2013 00032704 1 MB 0405 REQUISITIONER: 513449 C I. I III. I. II II I I. II 111 I I CALLER: BLAINE MALLABER CUSTOMER PHONE: (317) 571-2634 — CARMEL WASTEWATER UTILITY ORDER/DELIVERY#: 1173917428 760 3RD AVE SW STE 110 INCO TERMS: FOB ORIGIN STE110 CARMEL, IN 46032-2070 INTHANK YOU! FEI NUMBER 36-1150280 FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 1-877-202-2594 •• • e e ° - ••n • The following items were shipped to: BLAINE MALLABER CITY OF CARMEL WWTP 9609 HAZEL DELL PKWY *� INDIANAPOLIS IN 46280 000003 13F875 MOUNTING BODY,IGANG,3/4IN,FEED-THRU,IRO 1 61.99 61.99 MANUFACTURER# EDSC271 NUMBER OF PKGS.0 WEIGHT:0.00 INVOICE SUB TOTAL 6194 These Items are sold for domestic consumption In the United States If exported,purchaser assumes full r�cnnnchiGhi fnr rr+rt+nbanrp un4h I IC axnnrt rnntrnlc VOUCHER # 126727 WARRANT # ALLOWED 351533 I' IN SUM OF $ GRAINGER INC DEPT. 804491322 PALATINE, IL 60038-0001 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 9066161895 01-7202-06 $368.56 r Voucher Total 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 351533 GRAINGER INC Purchase Order No. DEPT. 804491322 Terms PALATINE, IL 60038-0001 Due Date 2/21/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/21/2013 9066161895 $368.56 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 L�Z v// Date Officer PAGE 1'01F 1 ® - � GRAINGER ACCOUNT NUMBER 854052545 3 O� INVOICE NUMBER 9064012371 401 S. WRIGHT ROAD / 7 INVOICE DATE 02/11/2013 JANESVILLE,WI 53546 / DUE DATE 03/13/2013 www.grainger.com (Z� AMOUNT DUE 39.60 Ship to information is listed below PO NUMBER: 050783157 in the description section REQUISITIONER: JEFF BARNES CALLER: JEFF BARNES BILL TO CUSTOMER PHONE: (317) 571-2448 MDG2013 00029927 1 MB 0405 ORDER/DELIVERY#:6219851246 'Il'��II��I'I��II��III'I�'III'III11�11111�1'111..1"I1�1'll�l�ll INCO TERMS: FOB ORIGIN CITY OF CARMEL/BOARD OF PUBLIC WORK 1 CIVIC SQ CARMEL, IN 46032-2584 THANK YOU! FEI NUMBER 36-1150280 FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 1-877-202-2594 e • • e ITh e following items were shipped to: TY OF CARMEL/BOARD OF PUBLIC WO NE CIVIC SQUARE RMEL IN 46032 ** 000001 22N664 LED FLASHER CONTROL MODULE 12V 1 39.60 39.60 MANUFACTURER# M50910 D FEB 2 5 2013 By NUMBER OF PKGS'0 WEIGHT 0.25 INVOICE SUB TOTAL 3960 DATE SHIPPED 02/11/2013 CARRIER:UPS GROUND/NO SAME DAY SERVICE These items are sold for domestic consumption in the United States If exported,purchaser assumes full responsibility forcompliance.with US export controls - PAYMENT TERMS NET 30 DAYS PAY THIS INVOICE NO STATEMENT SENT PAYABLE IN U.S DOLLARS AMOUNT DU "9.60 I ............... t �.;,-;.- _ .............. .............................................. PAGE 1 OF 2 GRAINGER. GRAINGER ACCOUNT NUMBER 854052545 —_ I11®® INVOICE NUMBER 9064672752 8211 BAVARIA ROAD 370, INVOICE DATE 02/12/2013 MACEDONIA,OH 44056-2259 DUE DATE 03/14/2013 www.grainger.com 2� AMOUNT DUE 129.34 I = Ship to information is listed below tion section RE NUMBER: 050789346 in the description REQUISITIONER: JEFF BARNES ®_ CALLER: JEFF BARNES — BILL TO CUSTOMER PHONE: (317) 571-2448 MDG2013 00031158 1 MB 0405 ORDER/DELIVERY#:6219963342 �I��II"��'I'I�'�'I��IIII�I�I�I�'11'111"'�IIII111'll'll�ll'llll INCO TERMS: FOB ORIGIN CITY OF CARMEL/BOARD OF PUBLIC WORK =- 1 CIVIC SQ CARMEL, IN 46032-2584 x THANK YOU! FEI NUMBER 36-1150280 FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 1-877-202-2594 ®_ •• ®_ -DESCRIPTION ITEM# QUANTITY UNIT PRICE TOTAL - 6'C The following items were shipped to: CITY OF CARMEL/BOARD OF PUBLIC WO ONE CIVIC SQUARE CARMELIN 46032 000001 1AYZ4 CLAMP,OD 1/4 IN,1/2 IN W,VINYL,PK 50 1 14.26 14.26 MANUFACTURER# COV0509Z1 000002 1AZG2 CLAMP,OD 1/2 IN,1/2 IN W,VINYL,PK 50 1 16.46 16.46 MANUFACTURER# COV0909ZI 000003 IAYZ8 CLAMP,OD 3/8 IN,1/2 IN W,VINYL,PK 50 1 13.97 13.97 MANUFACTURER# COV0709Z1 000004 1AZL3 CLAMP,OD 3/4 IN,1/2 IN W,VINYL,PK 50 1 18.43 18.43 MANUFACTURER# COV1309Z1 000005 1AZL1 CLAMP,OD 5/8 IN,1/2 IN W,VINYL,PK 50 1 18.34 18.34 MANUFACTURER# COV1109Z1 000006 1AZL8 CLAMP,OD 1 IN,3/4 IN W,STEEL,VINYL,PK 2 1 14.89 14.89 MANUFACTURER#COV1713ZI 000007 1EMY5 CABLE CLAMP,NYLON,1/4 IN,PK 25 4 1.26 5.04 MANUFACTURER# 22CC37DO250 000008 1ENE3 CABLE CLAMP,NYLON,1/2 IN,PK 25 4 1.70 6.80 MANUFACTURER# 22CC50DO500 I n l CONTINUED NUMBER OF PKGS.0 WEIGHT:7.42 C INVOICE SUB TOTAL 129.34 DATE CARRIER UPS GROUND FEB 2 5 2013 TRACKING NO:1Z3018W70301316432 These Items are sold for domestic consumption in the United States. If exported,purc anyssumes full resp^nsibdity for-compliance with US export controls. AMOUNT UE 929.34 PAYMENT TERMS NET 30 DAYS.PAY THIS INVOICE NO STATEMENT SENT.PAYABLE IN U S.DOLLARS I -`, R Z PAGE 2 OF 2 11� GRAINGER ACCOUNT NUMBER 854052545 INVOICE NUMBER 9064672752 ° 8211 BAVARIA ROAD INVOICE DATE 02/12/2013 - MACEDONIA, OH 44056-2259 DUE DATE 03/14/2013 AMOUNT DUE 129.34 BILL TO: CITY OF CARMEL/BOARD OF PUBLIC WORK 1 CIVIC SQ CARMEL,IN 46032-2584 SHIP TO: CITY OF CARMEL/BOARD OF PUBLIC WO ONE CIVIC SQUARE - CARMEL, IN 46032 r� •• 0 0 • • •'• • 000009 1EMY9 CABLE CLAMP,NYLON,3 78 IN,PK 25 4 1.35 5.40 = MANUFACTURER# 22CC37DO375 a 000010 1ENF2 CABLE CLAMP,NYLON,3/4 IN,PK 10 5 1.28 6.40 MANUFACTURER# 22CC50DO750 =_ 000011 1EMY7 CABLE CLAMP,NYLON,5/16 IN,PK 25 2 1.40 2.80 = MANUFACTURER# 22CC37DO312 ®_ 000012 1ENF8 CABLE CLAMP,NYLON,1 IN,PK 10 5 1.31 6.55 ° MANUFACTURER# 22CC50D1000 VOUCHER NO. WARRANT NO. ALLOWED 20 Grainger IN SUM OF $ DEPT. 804491322 Palatine, IL 60038-0001 $168.94 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 9064012371 42-389.00 $39.60 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1205 9064672752 42-370.00 $129.34 materials or services itemized thereon for which charge is made were ordered and received except Monday, February 25, 2013 Director, Administrati n 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)) 02/11/13 9064012371 $39.60 02/12/13 9064672752 $129.34 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 GRAINGER. PAGE 1 ORIGINAL INVOICE "i�� L:y fi GRAINGER ACCOUNT NUMBER 847517521 8211 BAVARIA ROAD INVOICE NUMBER 9058040511 MACEDONIA,OH 44056-2259 02/04/2013 www.grainger.com INVOICE DATE DUE DATE 03106/2013 SHIP TO AMOUNT DUE $2.96 ATTN:NO DEL AFTER 4:00 PM MONON CENTER PO NUMBER MC003786A 1235 Central Park Dr E PROJECT/JOB: MC003786A Carmel IN 46032 ' 7BY: � �" Z '/ ED REQUISITIONER: MC003786A CALLER: DAWN KOEPPER GEBCp C 201 CUSTOMER PHONE: 3175734026 5 ORDER/DELIVERY#: 6219269457 INCO TERMS: FOB ORIGIN BILL TO CARMEL CLAY PARKS&RECREATIONS ADMINISTRATIVE OFFICE 1411 E 116TH ST CARMEL IN 46032 THANK YOU! FEI NUMBER 36-1150280 FOR QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 877-202-25594 PO ITEM# DESCRIPTION QUANTITY BACK UNIT PRICE TOTAL LINE# ORDERED 1 3LP21 CABLE TIE,11.81N,PK100 1 2.96 2.96 MANUFACTURER#3LP21 Purchase ZIP MS TD L" bar)v ers [)�~cription P.C).# Me, C)C)"31%(CA Poor F G.L.# IOgI�I'lo0� Budget Line Descr Purchase Ri Date 2Ab±± ) Approval Date NUMBER OF PKGS: WEIGHT:0.350 INVOICE SUB TOTAL 2.96 DATE SHIPPED.02/04/2013 CARRIER:UPS GROUND TRACKING NO:1Z3018W70300791975 These items are sold for domestic consumption in the United States.If exported,purchaser assumes full responsibility for compliance with US export controls. PAYMENT TERMS Net 30 days -PAY THIS INVOICE.NO STATEMENT SENT.PAYABLE IN U.S DOLLARS. AMOUNT DUE $2.96 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 319510 Grainger Terms Dept 847517521 Date Due Palatine, IL 60038-0001 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 2/4/13 9058040511 Zip ties to hang banners $ 2.96 Total $ 2.96 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 20_ Clerk-Treasurer Voucher No. Warrant No. 319510 Grainger Allowed 20 Dept 847517521 .Palatine, IL 60038-0001 In Sum of$ $ 2.96 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO#or INVOICE NO. CCT#/TITLE AMOUNT Board Members Dept# 1096-60 9058040511 4239039 $ 2.96 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 21-Feb 2013 Signature $ 2.96 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund