223477 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 00353338 Page 1 of 1
ONE CIVIC SQUARE GEMPLER'S INC CHECK AMOUNT: $163.45
CARMEL, INDIANA 46032 PO BOX 5176
JANESVILLE WI 53547-5176 CHECK NUMBER: 223477
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 1019697945 163 .45 OTHER MAINT SUPPLIES
(Y"EOrder MPLUM D7Q @ On Phone: 1-800-382-8473 vv%v. -1726218 0 Orde r Online: www.Gemplers.com FEI#39-1726218
Order By Fax: 1-800-551-1128 1125 Deming Way
Madison,WI U.S.A.53717
PO Box 44993
Madison,WI USA 53744-4993
000252 PAGE 1 OF 1
6 CITY OF CARMEL S CITY OF CARMEL
ATTN: PARS PIFER H
R ATTN: PARRS PIFER
L 3400 W 131ST ST P 3400 W 131ST ST
T WESTFIELD IN 46074-8267 T WESTFIELD IN 46074-8267
0 0
Order No. P.O. No. Sold To No. Invoice No. Invoice Date Due Date
SC10409488 31257 5208827 - 1 1019697945 08/15/2013 09/14/2013
I
Buyer Carrier Freight Terms Ship Date Payment Terms
PIFER,PARRS UPSGNDHAZ LOCKED 08/14/2013 Net 30
QTY. QTY. UNIT
LINE PRODUCT NO.T DESCRIPTION B.0. SHIP U.O.M. AMOUNT AMOUNT
1 R97025 BIRD RPLLNT FLASH TPE TANGLE 0 8 RL 9.95 79. 60
2 163823 BYPAS HAND PRUNER 3/4IN 0 2 EA 25.70 51.40
3 G53112 PRNR HLSTR W/ SNAP WEAVER LE 0 1 EA 16.50 16.50
SUBTOTAL: 147.50
�- Thank you for your order. FREIGHT: 15.95
TAXES: 0.00
PN9217990804 N1
PAYMENT TERMS: Net 30 TOTAL AMOUNT DUE BY 09/14/2013 163.45 USD
These items are sold for domestic consumption in the United States. If exported, purchaser
assumes full responsibility for compliance with US export controls. ORIGINAL
°`tin 0 dr"d s torn g(it;,`ics (:;,:s,3 G. K .;fpe i a?-; Elramk L.LC till not bo respon-sible U? ,'how',°oof Of C<'.ni>vel jt.
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ON Tii`:':'. O ... .m!VEFK THE VTOODS COVERED BY THIS iPNOICE �-VERE "'RODLii.L-.D i;,1 '.'',QME'U'NNCE
V J 41 11 iE REQUiREAWN& 00 THE rAR L.°tF. _`R STANDARD'.-,FACT Of 108 AS AMENDED,
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01 SOME ;,iF' Ii..:, -,(•:` ,!'i .. ,.iNt.Tl`» F"ORUN,
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))
08/15/13 1019697945 $163.45
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Gempler's
IN SUM OF $
P.O. Box 44993
Madison, WI 53744-4993
$163.45
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 1019697945 I 42-389.001 $163.45 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 AL M23,s 23, 2013
St.et�8Mr� i �f'ioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund