219330 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 357329 Page 1 of 1
ONE CIVIC SQUARE GIRARD INDUSTRIES
CARMEL, INDIANA 46032 6531 NORTH ELDRIDGE PARKWAY CHECK AMOUNT: $1,212.14
HOUSTON TX 7701-3507 CHECK NUMBER: 219330
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 119494 1, 212 . 14 MATERIALS & SUPPLIES
GIRARD Invoice Number:,119494
Girard Industries INVOICE
UW 6531 North Eldridge Parkway Invoice Date:l 03/28/13
Houston,Texas 77041-3507 Page: 1
Ph: 713-466-3100 Fax: 713-466-8050 Customer No.: 4078
TM ALL AMOUNTS STATED IN US DOLLARS
B 4078 S 9609
Carmel Wasterwater Utilities H Carmel Waste Water Treatment Plant
L Attn: Paul Arnone f Attn: Blaine Mallaber
L 760 Third Avenue S.W Suite 110 P 9609 Hazel Dell Parkway i
Carmel, IN 46032 Indianapolis, IN 46280
HOT T
O
ORDER PURCHASE ORDER SLSRP SHIP DATE FRT.TERMS SHIP VIA ! TERMS
95973 S13521 LC 03/27/13 Ex-Works Packed UPS Ground PPA** Net 30 Days
I
ITEM PART DESCRIPTION U/M ORDERED B/O SHIPPED UNIT PRICE NET PRICE
1 RCCWB02.625M 2-5/8" OD Girard Red Criss-Cross Stainless Steel Ea. 12 12 100.00 1,200.00
Wire Brush Pig with Magnet for Cleaning Heat
Exchanger
Your Item No. 9511 /Account Code 01.7202.05
:_INVOICE SUB TOTAL'a,.`." .`;> '.: MISCELIANEOU8-- :',;: s' SALES:TAX`;' FREIGHT:. °
1,200.00 0.00 0.00 12.14 4 1,212.14 USD
RETURN GOODS NOT ACCEPTED
UNLESS ACCOMPANIED BY RETURN THIS ORDER IS SUBJECT TO THE TERMS AND CONDITIONS STATED ON THE REVERSE SIDE OF THIS FORM.
MATERIAL AUTHORIZATION(RMA)NUMBER
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
357329
GIRARD INDUSTRIES Purchase Order No.
6531 N. ELDRIDGE PARKWAY Terms
HOUSTON, TX 77041-3507 Due Date 4/16/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/2013 119494 $1,212.14
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
�/`//3 ci✓ o�ly c``1 e
Date Officer
VOUCHER # 135310 WARRANT # ALLOWED
357329
IN SUM OF $
GIRARD INDUSTRIES
6531 N. ELDRIDGE PARKWAY
HOUSTON, TX 77041-3507
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
119494 01-7202-05 $1,212.14
Voucher Total $1,212.14
Cost distribution ledger classification if
claim paid under vehicle highway fund