217669 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 359478 Page 1 of 1
:. ONE CIVIC SQUARE HILLYARD/INDIANA
CHECK AMOUNT: $748.65
CARMEL, INDIANA 46032 P 0 BOX 872361
s?� KANSAS CITY MO 64187-2361
CHECK NUMBER: 217669
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 600573847 748 . 65 OTHER EXPENSES
www.hillyard.com
Remit To: ................ .. .. ....
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HILLYARD HILL YARD INDIANA ...........
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3%Nhw§NI#N P.0 Box:872361 Customer Number: 272994
THE CLEANING RESOURCE' Kansas City, MO 64187-2361 Invoice Number 600573847
Plant: 1350
Phone: 765 378 3766 Invoice Date 02/11/2013
Fax: 765 378 6671 Purchase Order No. S13468
Packing List Number 85515055
Ship CARMEL W.W.T.P. - WASTEWATER UTILIT
To 9609 HAZEL DELL PARKWAY Sales Order Number 39053497
INDIANAPOLIS IN 46280 Payment Terms Net due in 30 days
1111111111111111111111H IN IN Page 1 of I
Bill CARMEL UTILITIES 600573847
To LISA KEMPA
760 THIRD AVENUE SW - SUITE 110
TOOUA u
Mo. n ... .......
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CARMEL IN 46032
PLEASE DETACH AT THE PERFORATION ABOVE AND RETURN THE STUB WITH YOUR PAYMENT.IT WILL INSURE PROPER CREDITING TO YOUR ACCOUNT.
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.Invoice;:.
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ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT
oolo PAP1 0110 2 CS 48.86 97.72
TOWEL ROLL GSC NAT WHT CONTROL 6 800 CS
0020 PAP1 0170 2 CS 47.89 95.78
TISSUE OPTICORE GSC 2 PLY 36 865 CS
0030 PG53971 3 CS 54.41 163.23
TOWEL BOUNTY 30 RLS
0040 PAP1 0145 2 CS 36.00 72.00
TISSUE FACIAL GSC 2 PLY 30 160 box
0050 LR4348150K 2 CS 37.20 74.40
LINER 56GAL 43X48 1.5M I L ELK 1 OO/CS PAYL
0060 HIL0103954 12 EA 2.87 34.44
GERMICIDAL FOAMING CLEANER 20 OZ
0070 HIL01061 6 EA 13.79 82.74
WIPE WATERLESS HAND CLEANER 72 CT
0080 KIM34015 6 CS 18.89 113.34
-\All PER AVY-PALL TERI-1-80 CS
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Subtotal 733.65
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Shipping 15.00
Tax Amount 0.00
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Gross Price 748.65
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Invoice Number 600573847 Date 02/11/2013 Purchase Order:S13468
Plant. 1350 Customer Number 272994 CARMEL W.W.T.P.-WASTEWATER LITILIT
HILL YARD 1INDIANA
HILLYARD P. 0.Box:872361 Invoice
NN9*N#N% Kansas City, MO 64187-2361
THE CLEAMG REsoURCE' CUSTOMER COPY THANK YOU!
THE SELLER REPRESENTS IT HAS FULLY COMPLIED WITH THE PROVISIONS OF THE FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED,IN THE MANUFACTURE OF GOODS COVERED BY THIS INVOICE.
VOUCHER # 126715 WARRANT # ALLOWED
359478 IN SUM OF $
HILLYARD/INDIANA
PO BOX 872361
KANSAS CITY, MO 64187-2361
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
600573847 01-7202-05 $748.65
Voucher Total $748.65
Cost distribution ledger classification if
claim paid under vehicle highway fund
i
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
359478
HILLYARD/I N DIANA Purchase Order No.
PO BOX 872361 Terms
KANSAS CITY, MO 64187-2361 Due Date 2/21/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/21/2013 600573847 $748.65
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