220647 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 357702 Page 1 of 1
` ONE CIVIC SQUARE HYDRAULIC COMPONENT SPECIALIST
CARMEL, INDIANA 46032 13595 LANDSER PLACE HECK AMOUNT: $142.89
? CARMEL IN 46033 CHECK NUMBER: 220647
CHECK DATE: 6/4/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 5644BS 142 . 89 REPAIR PARTS
Hydraulic Components Specialists, LLC Invoice
13595 Landser Place
Carmel, IN 46033 Date Invoice#
5/20/2013 5644BS
Bill To Ship To
Carmel Street Department Carmel Street Department
3400 W. 131 st Street 3400 W. 131 st Street
Carmel, IN 46074 Westfield, IN 46074
P.O. No. Terms Account# Job Description
-- - -I---JcY1'-Stcv.art I Net 30 250167
Qty Item Description Unit Price Amount
Supply Input Seal Kit
1 Seal Kit 132.50 132.50
1 Freight 10.39 10.39
Sales Tax (7.0%) $0.00
Total $142.89
Shop: 5438 Barker Lane Indianapolis, Indiana 46236 Payments/Credits $0.00
Phone (317) 895-6916,
Fax (317) 895-6927 Balance Due $142.89
Conditional limited warranty as determined by
Hydraulics Component Specialists LLC
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hydraulic Components Specialists, LLC
IN SUM OF $
13595 Landser Place
Carmel, IN 46033
$142.89
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT
_ Board Members
2201 I 5644BS I 42-370.001 $142.89 1 hereby certify that the attached invoice(s), or
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
f 1117
L . A All Y . j 2,urs 2013
S� 6atmis�sineer
Title
Cost distribution ledger classification if
claim paid motor 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 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))
05/20/13 5644BS $142.89
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
20
Clerk-Treasurer