217593 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 366945 Page 1 of 1
ONE CIVIC SQUARE CHROMALOX INC
0
CARMEL, INDIANA 46032 PO BOX 536435 CHECK AMOUNT: $347.86
ATLANTA GA 30353 CHECK NUMBER: 217593
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1113991 347 . 86 OTHER EXPENSES
Chromaloic INVOICE DATE + INVOICE NO.
02/11/13 ® 1113991
PRECISION HEAT AND CONTROL
103 Gamma Drive Ext. * Pittsburgh, PA 15238 * USA
www.chromalox.com Chromalox, Inc
P.O. Box 536435
Contact Your Local Chromalox Representative: Atlanta GA 30353-6435
DAVE RAY&ASSOCIATES (15)at 248 280-0000
Sold To:
Ship To:
CITY OF CARMEL-UTILITIES City of Carmel-Utlities
3450 W 131st St 4915 East 106th Street
Carmel, IN 46074-8267 Attn: Tim
Carmel IN 46033
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Page 1
CUSTOMER ORDER NO. CUSTOMER SHIP7O`'N0. CUSTOMER SOLD TO NO. 7E'0UE DATE:
TV13113 38968 38967 03/13/13
OUR ORDER NO. PAYMENT TERMS DATE SHIPPED SHIPPED FROM ORDER STATUS
2105700 Net 30 days 02/11/13 LAIR x
COMP INCOMP
ITEM MODEL NO.I DESCRIPTION PC I PART NO. QUANTITY UNIT PRICE EXTENSION
j
SHIPPED
2 KIT-MOTOR,120/230/277,HD3D 053169091 1 091 328.00 328.00
3 Shipping & Handling 126ROW430367270622 1 19.86 19.86
4 Shipping & Handling UPS GND PPC LN 2 1
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PRE 1EAT AND-
CONTROL
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To check order status, obtain product information, inquire about service, or to place an order ' ' �'.,'
lum
contact your local representative,visit www.chromalox.com, or call: (800)443-2640.
To pay by credit card call (412)967-5147 $347 . 86
This document „is _governed by the Terms and Conditions of Sale of Chromalox, Inc. set forth at
http://www.chromalox.comlcustomer service/po li&iesltermsofsale-.aspx,-which are incorporated-herein-by.reference,--
and the parties consent to the incorporation.
1'yyj1CQMPLY WITH THE REQUIREMENTS OF THE FAIR LABOR STANDARDSACT OF 1938 AS AMENDED" THANK YOU
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
366945
CHROMALOX INC Purchase Order No.
PO BOX 536435 Terms
ATLANTA, GA 30353-6435 Due Date 2/19/2013
Invoice Invoice Description'
Date Number (or note attached invoice(s) or bill(s)) Amount
2/19/2013 1113991 $347.86
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 # 123621 WARRANT # ALLOWED
366945 IN SUM OF $
CHROMALOX INC
PO BOX 536435
ATLANTA, GA 30353-6435
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1113991 01-6200-04 $347.86
Voucher Total $347.86
Cost distribution ledger classification if
claim paid under vehicle highway fund