217709 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 00351074 Page 1 of 1
ONE CIVIC SQUARE KIMBALL-MIDWEST
CARMEL, INDIANA 46032 DEPT L-2780 CHECK AMOUNT: $169.00
COLUMBUS OH 43260-2780
„ CHECK NUMBER: 217709
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 2805812 169 . 00 OTHER EXPENSES
110' DA&S-
WIMBALL INVOICE INVOICE NO. NET I DAYS
'S1 PLEASE PAY FROM THIS INVOICE 2805812
IDS T ORIGINAL ORDER NO. •
Spr, ulizinE irx AtGteriuis.Mlar unerneri.'sink 1923 0 5 2 4 6 3 2 E
•
REMIT TO: KIMBALL MIDWEST
ACCOUNT NO.
DEPT. L-2780
COLUMBUS, OHIO 43260-2780 (614-219-6100) 65060 • • •
www.kimbalimidwest.com
SOLD TO: SHIP TO:
CARMEL WATER DISTRIBUTION CARMEL WATER DISTRIBUTION
3450 WEST 131ST ST 3450 WEST 131ST ST
CARMEL IN 46032 CARMEL IN 46032
�\f JIM HAAG
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DATE ISALES REPRESENTATIVE1 PURCHASE ORDER NO.1 SHIPPED VIA& DATE
01/28/13 COHEN, ROBER JIM U UPS GROUND 01/28/13
ORDERED SHIPPED BALANCE DESCRIPTION UNIT PRICE AMOUNT
DUE
1 1 402314U PRO-TECH II TERM ASS' 169 . 00
SPF_538:
CATALOG- :(UPDATED _ 0,0
UPS TRACKING #: 1Z47817303395043 0 WGT: 9
UPS: TRACKING :# : 47817303395083 Q; W,GT:1
To help us correctly process yo r payment please
include :invoice number: on: your:: erni'ttan,ce 'advice
thank yol tor :your. bus ness ! , Payment, is: due 02/2'7/13:
ease ,m i1 :by: 02/20/13:
Fo recei e invoices via email send a request inc uding you
B;ccount.` umber :to _invoice:@}c znballMidwes't.com
You acknowledge and agree that,by placing this order,all information provided to you by Kimball Midwest herein is confidential and is the property of Midwest
Motor Supply Co.,Inc.d/b/a Kimball Midwest.You further agree that this information is for your internal use only and will not be copied,reproduced,distributed
or disclosed by you and/or your organization without the prior written consent from Kimball Midwest.
CARRIERS RECEIPT IN GOOD ORDER CON- ORDERED TAX% TAX AMT. SHIPPING INVOICE TOTAL
STITUTES DELIVERY AND CLAIMS FOR L053
OR DAMAGE IN TRANSIT MUST BE FILED BY
CUSTOMER.
GOODS RETURNED WITHOUT OUR CONSENT
WILL POSITIVELY NOT BEACCEPTED 169. 00 169 .00
DEBTOR IS LIABLE FOR USUAL AND CUSTOM-
ARY COLLECTION CHARGES.
ALL CHECKS MUST BE MADE PAYABLE ONLY
TO"KIMBALL MIDWEST We Appreciate Your Business PLEASE REMIT THIS AMOUNT
VOUCHER # 123573 WARRANT # ALLOWED
3551074 IN SUM OF $
KIMBALL MIDWEST
Dept L-2780
Columbus, OH 43260-2780
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2805812 01-6500-05 $169.00
Voucher Total $169.00
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
3551074
KIMBALL MIDWEST Purchase Order. No.
Dept L-2780 Terms
Columbus, OH 43260-2780 Due Date 2/18/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/18/2013 2805812 $169.00
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