223103 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 365006 Page 1 of 1
`•` ONE CIVIC SQUARE NALCO CROSSBOW WATER
CHECK AMOUNT: $190.00
CARMEL, INDIANA 46032 NETWORK PLACE 24658
CHICAGO IL 60673 CHECK NUMBER: 223103
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
6S1 5023990 2113669 190 . 00 OTHER EXPENSES
CROSSBOW
. .. .._ ., k,, Invoice
Nalco Crossbow Water
Network Place 24658
Chicago, IL 60673 = ,:
USA ; Invoice:No" 2113669
C istomerfNo r 0310060A
Bill To: -Ship TO...,
CITY OF CARMEL WASTEWATER UTILITIES CITY OF CARMEL WASTEWATER UTILITIES
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Indianapolis, IN 46280 Indianapolis, IN 46280
Contact: Tara Washington Contact: Tara Washington
Telephone: 317-571-2634 210 Telephone: 317-571=2634 210
Invoice Datel Order Date" SO Number Ordered By Customer PO Number Payment,.Method
07/18/13 07/11/13 1 Net 30
Warehouse. Ship Via F.O:B: Salesperson -Resale•Number'
INDY Crossbow Truck Chris Coppock
Order.' :.Ship _ Unit Extended,
Tax. Item.Num6er/Description
'Qua tiiy :Quantity Price.
2 2 Y DMD I U of M: EACH 95.0000 190.00
DI EXPRESS
IT SERVICE EXCHANGER
01 D80 FRP MIXBED
I
;fcYrii t;Dat, 07/19/13 Due•Dafe 08/17/13 Sub"total:: 190.00
PrintTime' 03:04:06 PM $,-s ;Freight 0.00
Printed By: Rachel Sissman Total Paid• 0.00
Balance Due' 190.00 Invoice Total 190.00
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
365006
NALCO CROSSBOW WATER Purchase Order No.
NETWORK PLACE 24658 Terms
CHICAGO, IL 60673 Due Date 8/6/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/6/2013 2113669 $190.00
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
VOUCHER # 136130 WARRANT # ALLOWED
365006 IN SUM OF $
r
NALCO CROSSBOW WATER
NETWORK PLACE 24658
CHICAGO, IL 60673
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2113669 01-7202-05 $190.00
1
i
I
Voucher Total $190.00
Cost distribution ledger classification if
claim paid under vehicle highway fund