219397 04/24/2013 �,\*f CITY OF CARMEL, INDIANA VENDOR: 356915 Page 1 of 1
ONE CIVIC SQUARE L T RICH PRODUCTS INC
<. CHECK AMOUNT: $149.24
CARMEL, INDIANA 46032 920 HENDRICKS DR
a o� LEBANON IN 46052 CHECK NUMBER: 219397
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 35767 130 . 16 REPAIR PARTS
2201 4237000 35925 19 . 08 REPAIR PARTS
LT Rich Products, Inc.
.» 920 Hendricks Drive INVOICE
Lebanon, IN 46052 Date Invoice#
4/17/2013 35925
Bill To Ship To
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 WEST 131 ST ST. 3400 WEST 131 ST ST.
CARMEL, IN 46074 CARMEL, IN 46074
USA USA
• • No. Terms Due Date Ship Date
DUE ON DELIVERY 4/17/2013 4/17/2013 U.S. Fed Ex Grou
Description Qty Rate Amount
80404 - HYDRAULIC FILTER 2 9.54 19.08T
Oat-of-state sale, exempt from sales tax 0.00% 0.00
Total $19.08
Payments/Credits $0.00
Balance Due $19.08
Phone# Fax# E-mail
765-482-2040 765-482-2050 lauriekiefer@hotmail.com
0 Z LT Rich Products, Inc.
920 Hendricks Drive INVOICE
Lebanon, IN 46052 Date .Invoice#
4/12/2013 35767
Bill To Ship To
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 WEST 131ST ST. 3400 WEST 131ST ST.
CARMEL, IN 46074 CARMEL, IN 46074
USA USA
• • No. Terms Due Date Ship Date Via
4/12/2013 4/12/2013 U.S. Fed Ex Grou
Description Qty Rate Amount
80505 - 17 HP IGN. COIL 1 34.65 34.65T
80505-B - 15 HP IGN. COIL 1 35.20 35.20T
70008- SMALL HOPPER COVER 1 2 2.31 22.31T
60000-Lavender-AVI-110025 1/3 SPRAY TIP 4 9.50 38.00T
Out-of-state sale, exempt from sales tax 0.00% 0.00
i
Total $130.16
PaymentslCred its $0.00
Balance Due $130.16
Phone# Fax# E-mail
765-482-2040 765-482-2050 lauriekiefer a hotmail.com
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))
04/12/13 35767 $130.16
04/17/13 35925 $19.08
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.
ALLOWED 20
LT Rich Products Inc
IN SUM OF $
920 Hendricks Drive
Lebanon, IN 46052
$149.24
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE FTMOUNT Board Members
2201 35767 42-370.00 $130.16 1 hereby certify that the attached invoice(s), or
2201 35925 42-370.00 $19.08 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
a
I 19, 2013
Streeter&jmWsioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund