HomeMy WebLinkAbout224961 10/08/2013 CITY OF CARMEL, INDIANA VENDOR: 00351017 Page 1 of 1
ONE CIVIC SQUARE KIRBY RISK ELECTRICAL SUPPLY
CARMEL, INDIANA 46032 PO BOX 664117 CHECK AMOUNT: $10,230.42
� INDIANAPOLIS IN 46266
CHECK NUMBER: 224961
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 5, 750 . 00 S107023270 . 001
601 5023990 117 . 66 5107110122 . 001
601 5023990 119 . 23 S107112613 . 001
601 5023990 4 , 065 . 62 5107160356 . 001
651 5023990 53 .40 S107126749 . 001
651 5023990 124 . 51 S107128107 . 001
Kirby is - INVOICE
1815 Sagamore Pkwy
Lafayette, IN 47904 09/27/13 S107128107.001 74918
. . 0 ! • e
10/31/13 124.51
KIRBY RISK CORPORATION
P.O. BOX 664117
INDIANAPOLIS IN 46266-4117
619 1 MB 0.405 E0339 10549 D786500967 P1626015 0002:0002 SHIP TO:
IIII��I���I�'ICI'I...ICI"ICI"I�III��IIII�I�I���I�II�II11�'I�'I' CARMEL WWTP
CARMEL WWTP ATTN: BLAINE MALLABER
FaATTN: PAUL ARNONE 9609 HAZEL DELL PKWY
9609 HAZEL DELL PKWY INDIANAPOLIS IN 46280-2935
INDIANAPOLIS IN 46280-2935
----------------------------------------------------------------------------------
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
• • •
74918 LARRY PT 10TH PROX NET 30TH
MARK S BAYS PK PICK-UP LARRY FISHERS 317-598-6170 09/27/13
500ft 500ft CORD MTW-16-BLU-50OFT 79.41 1000ft 39.71
16-26 CU TEW/AWM/1 01 5/1230/1032/MTW
BLUE
65311301
500ft 500ft CORD MTW-16-RED-50OFT 79.41 1000ft 39.71
16-26 CU TEW/AWM/1015/1230/1032/MTW
RED
65307101
500ft 500ft CORD MTW-16-BLA-50OFT 79.41 1000ft 39.71
16-26 CU TEW/AWM/1015/1230/1032/MTW
BLACK
65305501
2ea 2ea SIEM EC2GB15 2.69 lea 5.38
GROUND BAR KIT-15 POS
D�
Billing Questions:Billing—request@kirbyrisk.com(765)446-3054 9127001311:02:02 AM 6107129107.001 Invoice Number S107128107.001
Subtotal 124.51
S&H Charges 0.00
Invoice is due by 10/31/13. Sales Taxi 0.00
-/ ® ® 124.51
000z:000z
K'it Jy Risk Page 1 of 1
���� ���� ---- ------
�
TERMS AND CONDITIONS OF SALE
ACCEPTANCE OF THE GOODS PURCHASED ON THIS INVO&CFCONTsIITQTES AND
ACCEPTANCE OF THE TERMS AND CONDITIONS OFSALE WHICH FOLLOW:
(l) Stock Merchandise is subject tnu return charge, 74o goods may bx returned vvit600ta shipping ticket
and/or invoice number and prior authorization.
(2) Non-Stock Merchandise is not returnable unless we can secure a"Returned.(3oods Authority" from
the vendor.
(3) The Customer acknowledgesand agrees that in all purchases ofgoodsand*ervices from Seller. Seller
�jvcs no express warranties.or implied warranties of merchantability and fimess llor anN. particular
|nx�nsc
(4) Thc Customer ogmc*that Seller will not be liable forany couyrqucn|io\ and incidental Jnmugcxurixb/y
from uny cause associated with the goods PLu-Chuoud front Seller.
(5) Taxex— Pricexshowndonminclode sales m other taxes imposed on the sale of gpods. Taxes now m
hereafter imposod Upon sales or shipments will be added m the purchase price, Buyzrauoomm
o:i1obucxo3dlucfbruuysuobnaxorp/ovidcScUzrvi/hacccpzub|ctuzexcmphoucortiGuuto.
K0 Delay in Delivery—Seller ienot tobn accountable for delays io delivery occasioned by acts oil'God or
other circuonsmocca over which Seller has no direct control. Faccory shipment or delivery dates are the
best estimates Of OU.r suppliers.. and in no case sliall Seller be liable for any consequential or special
dumuges arising 6nno any delay indc|ivcry,
(7) Waiver—The 8J|uruof Seller 1n insist upon dhcperformance ofunyn[the/ennsor conditions nfdhio
contract or to cxerciseany right hereunder shall not be deemed to bea waiver of such terms,
conditions orridit in the 6u/ure, nurshuU i/bc dcznuJtohe avaivcruFmoy other rc,m. uuodidon,or
right Linder this contract.
88) Modification uYT,rnm and Conditions—Nnteons and cuodi6nno other than those stated herein,and
no agreement Or understanding, in any--WaV purporting to modify,these terins. or conditions, shall be
-- biadbn"on8eUff*idu`mScOcr's written.consent.
Kirby Risk
INVOICE
0 D • •
1815 Sagamore Pkwy
Lafayette, IN 47904 09/26/13 S107126749.001 74918
D e • D e D
10/31/13 53.40
KIRBY RISK CORPORATION
P.O. BOX 664117
INDIANAPOLIS IN 46266-4117
SHIP TO:
E0027 10194 D785484427 P1623834 0006:0006
'11'1'1'1111111111 III, CARMEL WWTP
CARMEL WWTP ATTN: BLAINE MALLABER
{� ATTN: PAUL ARNONE 9609 HAZEL DELL PKWY
9609 HAZEL DELL PKWY INDIANAPOLIS IN 46280-2935
INDIANAPOLIS IN 46280-2935
------------------ ----------------------------
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
MCA!i
• • •
74918 SHOP PT 10TH PROX NET 30TH
MARK S BAYS PK PICK-UP BLAINE FISHERS, 317-598-6170 09/26/13
OEM
30ea 30ea PHIL F34T12/CW/EW/LL ALTO 30PK 1.78 lea 53.40 1.07
142513
KRDP
**SUBJECT TO VENDOR RETURN POLICY**
Billing Questions:Billing request @kirbyrisk.com(765)446-3054 9f2612013 2:59:27 PM S107126749.001 Invoice Number S107126749.001
Subtotal 53.40
If paid by 10/10/13 you may deduct$1.07 S&H Charges 0.00
Invoice is due by 10/31/13 net of any cash discount. Sales Tax 0.00
BLAINE _ ® ® 53.40
0006:0006 Kirby Risk Page 1 of 1
TERNISAND CONDITHAS OF SALE,
AfTEPTANCE M—RIE GC;ODS PURCELKED ON MIS INVOIC11(XINSTITIMMIND
ACCEPTANCE OFT11F,'HERNIS AW U)NDITIONS CHI SALEMIKS RMA.M.
k!) WO, Merchan;Hse is mIject in it rourri Jwqx. No
'ra itnv",i o.,,,,ihcr and pri ,,r
Nol-�-,Stock-�vlvlwhaadise is ma nrunvabic Wc ni we can sccuv,,i-1Rctarn-,,,o,
V a omArr,
Q Tw Uvolmi sAxWedps va Lgmcs IM A, 01 powhawn ol, goods and 4.=vwws Kni SOn. Salkn,
P", vvlvnnnie, or and FOOV Rrraq ponn0i,
rwpuse
kv P� Unsn'r Y�nvw Owl SWAn 0 d! W lit halo Am an, Wnpn;W-Qj ann :W WS WAY, Mvq-"
cau,,c, J)Ul'ch,-m�J i,roul
(51 Mes- Prices lawn do not include sales or ofor taxes orl the of,�oo&, I DOW 101,
rcimbury SAW Or mq vuh my a-provide Why wilh a"MaW tax nwi"ion col-Ancriv,
k6l Mal in DeUver) ---KIM is noF to Win ac"symble Or Mayq W davmy w wwOnA by v" X GaM,
mor alrainviNwn over which War has rvi direct convol- lWory or deliver are Ore
lie laflo IV,for co�n,wq
i.fit ofour suppliors.and in no now .:r.a. ScIfel
danlfqi,esal any delny in
(7) Waiver—The LAW of Seher to innst uplo the pmhwuwHcv May of do iums or snOnks of alis
kynnam or to unrcke avy 60a its ninly Mull not be dceawd of 11v�I, waid c,- ofauch
E-On(hiioro or in the FuRur. nor Will it bc,d,,onv�d to he a waiver of arly ohn Wun, coldUmm or
rQjt uvrikw TV nomrac[,
(8) AMUMthun.of 111rms and flondUklirts—No amns and comMus Nhu On Uwse smed hertrin- and
undastanIng.in any way Impyalbrig U)nuKIFY these toTns. or condidon;, Mall tv
'inding on Soll"r xithow Sellor"', writ.ten con�,t lrt,
fat,
IHER # 136495 WARRANT # ALLOWED
1017 IN SUM OF $
'' IRBY RISK ELECTRICAL SUPPLY
. PO BOX 664117
INDIANAPOLIS, IN 46266
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
S107128107.( 01-7202-06 $124.51
5107)a67(4S.00%
01.7,90o').Oto 53-90
l-7
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
f
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
351017
KIRBY RISK ELECTRICAL SUPPLY Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 10/2/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/2/2013 S107128107. $124.51
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
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
11788 BT091913A NET 30 DAYS
MARK S BAYS DIRECT BRIAN TOLAN FISHERS 317-598-6170 09/25/13
lea lea TIME A252B 103.04 lea 103.04
3 PHASE 480V PHASE MONITOR
KRPNM
—SUBJECT TO VENDOR RETURN POLICY"
Billing Questions:Billing—request@kirbyrisk.com(765)446-3054 Invoice Number S107112613.001
Subtotal 103.04
SOH Charges 16.19
Invoice is due by 10/25/13. Sales Taxi 0.00
• � 119.23 �-
0001:0001 Kerby RiSk Page 1 of 1
TERNIS AND CONDITIONS OF SALI-E,
A(MPTANC17 ,01"IBE 60011S PURMIA.M.,.1)ONIIIIS INVOICF,('0NS'FTIA_"I Fo,;"�NND
ACCEPTANCE,01,''I'llETIE,101S Ala)(I)NDITHMS (WE SALE MTRAI FOLI,t *,
(1) Stock NUMMW is sul'ut 10 a retwo ehaqe. No goody up be ORMWI Ww"nut a Qt JIM
invoicc n�mlh -' andprioi,"kuthoriz-aCou.
(2) Nwokkock M chauMse is not imurnabIn nuns we can nVure;i A.:°ho, fran
On arnMr,
t 3 rho Costurnaawknow1odps amhyrus Mrs( h NJ pumhaws AluM and su.voons Go m SAW, SeHer
""iv"" no "'.'<Arrantic�,of irnplliod wnnnow"WrimmkimMy and Kwasq Oman, pndnbr
prrva,
(4) 1 he Clatortwu open that 011, 11if1 not N 3_€�.iC: CL4i any
1P)m aq tTone ovocnaed loth to goods jorck"scd 1A)m War
(5) loves.. p6ca �'hov�'n do not sale,or(qlwr raxev inloowd on be sk v?gw& I aws rum ol
ho Una but ood UqM sain or Aipaunts WO Ow Md Po Wo p°1., apt prwo Buyl air rMW
raMurne Set&: Qr Yq suh tax or pnPIA;SAW with ac "'unble 1w, cerrificpr'
5) Why M M%erj So%is not to be .cast= able for Mays in dedvery tv=Kwd by ac B 4God or
Ibe ,u , of dehve�'y are 11w,
C); ivhkh Mar has no dhxt comrol. ; S1
W!cstirnmes of our sipplOrs,and in no caw shil Wer be 451 IN any wnwqwMWi w sNchl
d' It c"s arisnn'_5' from ally delay in dlchvLn-y.
(7) Waiver--The Mure&:`dic to insist up Ni tho puRnmanu (gany YM in ray or w1whAms of tfli
Con[MCi or to e:CrCke wV QM hurnMy W11 not he Wm,d to he a wainx of,�ijch ten'ns,
C'olldlifiolls or rig"ni ia the futurc, no,, shag 4 he dnawd W bv a wAva of") Manerm, wmilkon, or
right undcr tlhi wcootraoL
(8) ModUhmMm oITwnw and ClundUhns—No horns and smAhms Mar Hun Own smod hucin.am]
no agivernwaorundaswndinW in anyway J:HnporthT U)modify ihcsc,i,erm°_ hC
on seilcr"" written c0flsc'n",
11788 BT091813 NET 30 DAYS
SALESPERSON.,
s . • ..
MARK S BAYS PK PICK-UP BRIAN TOLAN FISHERS 317-598-6170 09/18/13
100ea 100ea CULL 40725J 6.85 100ea 6.85
1/4 X 1-1/4 FENDER WASHER ZP
4ea 4ea BLIN B280SQZN 1685.14 100ea 67.41
POST BASE
100ea 100ea MINE 1B 43.40 100ea 43.40
HANGER W/BOLT-3/4"EMT/3/4"
RIGID
Billing Questions:Billing—request@kirbyrisk.com(765)446-3054 9118120139:42:20AM 6107110122.001 Invoice Number S107110122.001
Subtotal 117.66
S&H Charges 0.00
Invoice Is due by 10118113. --p��� Sales Tax 0.00
BRIAN TOLAN ® 117.66
000 1:000 1
Kirby Risk Page 1 of 1
_ .
TERMS AND CONDITIONS OF SAL.E
ACCEPTANCE OF THE GOODS PURCHASED ON THIS INVOICE CONSTITUTES AND
ACCEPTANCE OF THE TERMS AND CONDITIONS OF SALE WI-IlCDFOLLOW:
(1) Stock Nlerchandise IssubjeCt to a return charge. No goods may be returned ,,vithout a shipping ticket
and/or invoice number and prior on|budzoboo
(2) Non-Stock Merchandise io not returnable unless we can secure o^'Qztumncd [;nods/\ntboriL}/` frnm
the vendor.
(3) ThcCus|omcrocknnw|edgrauudagn:cs that inol| pu,chnuoymfgonduundyurircoOnm Seller. Seller
�givrm no express warranties.or implied wurmn600 o[morchuom6i/i|yund Gm^ou [6r any particular
purpose.
(4) The[us|omorxgmcythoz Seller will not be liable Onr any cmnsxgurutiu|und incidental damages arising
from ouycuusu onouuioted N-vkbthe goodnpurcbuxed from Sc\kz
(5) Taxes—Prices shown dnon/(oc1udcyu/csmr other taxes impouedm`the oulrof gooJ�. Taxes now o/
hcoollCr inzposmd Upon sales oryhipmcn/s will 6c added m the yumhoscprice. Buyer o8Joceto
/ri/nbuoe Seller for any such uz provide Seller with ucccpu6lo tax exemption certificate,
(h) Delay in Delivery—Seiler is not to be accountable for defays in delivery occasioned by acts ol"God or
other circumstances over which Seller has nn direct control. Factory shipment ordelivery dates are the
best estimates Of OUr suppliers,and in no case shall Seller be liable]'or any consequential or special
Jmnogcs arising from any delay indelivery.
(7) Waiver—The fiJ|urco[ScUcr/ninyistupon the pur6onnuncoo[anynf/hcuun*or conditions nfd/iu
contract or to exercise any right hereunder shall not be deemed to be a waiver ol'such terms,,
conditions nrriLh,in the 0/mm, nor shall i,hedccmoJu`hc n waiver oFooy other term., condition,or
right under this contract.
0; MludiDmhunufTcrmo and Cnndhinns—Noncnnyaod conditions m&c,thun \humeauted herein,and
no)agreement oz understanding,iouuy- Way yurpmu6ng/nmodjfy these terms, or conditions, shall br
binding on §nUcr without Seller's written consent.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
11788 W09842 NET 30 DAYS
IDMS-XML PAR PARCEL DLVY KEN RHODES FISHERS 317-598-6170 09/16/13
lea lea AB 1747-1-553 5750.00 lea 5750.00
SLC 5/05 PROCESSOR 64K MEMORY
Billing Questions:Billing—request@kirbyrisk.com(765)446-3054 Invoice Number S107023270.001
Subtotal 5750.00
SOH Charges 0.00
Invoice is due by 10/16/13. Sales Tax 0.00
• 5750.00
0001:0001 Kirby Risk Page 1 of 1
TERMS AND CONDITIONS OF SALE
ACCEPTANCE OFTHE GOODS PURCHASED ONTHlS INVOICE CONSTITUTES AND
A,CCEPTANCE' OFTDCIERMS AND C0NDFllO?4S8F SALE WHICH FOLLOW:
(1) S<uckM/cnchuodfise is robjrn to u/'Munncbm-e. No ,-,00dsmuy 6ercmrned vvidmuto shipping dvkm
aodFov invoice number and prior authorization,
(Z) Non-Stock Merchandise is not returnable unless we can secure^'Ronmxrd Goods Andiozitv' from
th�vcndor.
(3) ThcCuuiomrr and agmos that iouU purchases ofgoodouud services from SnOcr, Seller
oivex000xposexnrooxioo.orjmp|icdwunoniicao[murchuuuJili|y and 6nicxu66ruoypxrbculur
pmp0oc
(4) The Cuu|umurugrueythat Seller�iU not be {iob\o for any cons'eguco{iu\ and, incidomo} Jxmu_Qcn ari nioQ
buo anvcooso associated with the gxodoptnzbuued bmn Sdkz
(5) Tsxcx—Priccasbu*udonot illClodcadcsoroderoucyhoyoaedouLhesuleu[gxxn. Iuxoyno,/co
hcmuOcrbnpoycd1gpoo sales urehipmcnmn/ill bc added tu tile puzobuucPrice. 8uycrmLIrOuszo
mirohomC8clleribruuysucbtuxorp/ovidz86lcr,j/baoccpm01ztoxezcmpdoocertilicoto.
(6) Delay in DeliA cry—Seller is not to be accountable lor delays in delivery occasioned by acts ol'God or
other circumstances over which Seller has nn direct control. 1�actory shipment or delivery dares are the
best estimates of our suppliers, and iono case shall Seller be Uu6|o thr any consequential or special
damages arising from any delay iudelivery.
(7) kVaiver—The failure of'Seller to insist upon the performance ofany ofthe ternis or conditions of this
contract or to exercise any right hereunder shall not be deemed to be a WokTr Of SUCh tel-111S.
conditions orriab/ in the Ou{uru. nurshaU it be dccmcdto be o waiver u[ony o/horu,m,c0ndi6no,or
right under this contract.
0o Modification ofTeruns and Conditions—No ternis and conditions other than those stated herein,and
nnugromuoouozUnderstand i og.iu any way purporting[umodify these,cnoa, orcoodi6ony. shall be
binding oil Seller`vit6ou/ &61m'y Written consent.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
DETACH UPPER PORTION AND RETURN WITH YOUR PAYMENT
11788 W09860 NET 30 DAYS
• o•• • • • •
IDMS-XML 23 INDIANAPOLIS KEN RHODES FISHERS 317-598-6170 09/26/13
lea lea HOFF A484812WFLP 1069.51 lea 1069.51
TYPE 12 ENCL.48.00X48.00X12.0
2ea tea HOFF A24P24 50.78 lea 101.56
PANEL 21.00X21.00 FITS 24.00X2
3ea 3ea HOFF A24H2408GQRLP3PT 780.49 lea 2341.47
FG WALL MT TYPE 4X 3 PT
**SUBJECT TO VENDOR RETURN POLICY**
2ea 2ea HOFF A202008LP 276.54 lea 553.08
ENCLOSURE 20.00X20.00X8.00
Billing Questions:Billing—request@kirbyrisk.com(765)446-3054 Invoice Number S107106356.001
Subtotal 4065.62
S&H Charges 0.00
)nvdlce)s due by 10126113. Sales Tax 0.00
09 26 I
Sigt tore Date
yY nt �e �h' 0 4065.62
000�:000� Kirby Risk Page 1 of 1
TERMS AND CONDITIONS OF SALI-'.'�
A UMPTANCE 0FTHE G(,K)DS PU1.WJ1.`iSED.0NT1[IS
4CCEPTANCE 0FT11EA-1'J�MS AW U)NDITIONS MSAIT WMAI F(MA,"J'A'A
(n NMI MAW& is stRya-1, to�, !eturn Gha3 , No gookl�� i. ti% b,,,n-namv:�. J�J,ei
irrvoi wind"',r mid iii;,,arhovizakon,
(2) MWAM:Merchandise is uotv�.'uornabtc rnii,�s %,,c cm wcum a Asufnoo 600ds Awl"" Al" Ilmn
ow vomdor,
(3) h: .}"nd 11rr'a in 311 putchans . 1 gomk Knd s,n ins A,=Saks, Wer
11"3 Vv.,,o--i antios,o, ;-nplicd4k m,ln,,n 63 h and Kpay For any jym V War
impm.
(4) TY Cwrorm,,i U),n; S pr "di no be 1110AW up wwwwwraial and VW 40.1 Woq�ari,Q),
any(:aasi,,,ammiNd w1h to gumho punho"d Mmi S65r,
Me s. PAn Wwwn do no hwimb suRs orwhor taxes injowdon We W va'goods. T"rw xmtir
inop�: Cd Uma mW ou Ariprutsus Mil 1w added w Hw powhaw ralo Bu3nor agwas
Selk,r ii any such taN or Imovide 01hr mAh mwealk wx ewpMkm cerficme,
o(i) Delay in DeHuery--Sellor is not to h! .iccoum&Ac Ig dchys h i d ed very ;Yc;,ioncd by aws oF God w-
11<1S 110 do'Co, control, 1 ,.ctory �Inpoi. o.or dehver� .ov
W!Maincs A oor supplbry am! in no caw shail AM be Me Q any counquerahl or qyCial
in dclivCr,"..
(7) Waiver—The 1A1€.IP of SAW h)ti_:isr upon An inorformaucc of any ofQ;tans or comMots(A Wis
kimu&i or to svmke wy hot harundn AW not be d�,,ernc,! to bL;t. vaid A'°,ijch tt`,rn:�,,
i:,00difions or J-ighl in the Mae nor sfmll it kb,u nled.to hv of an" omhcl terin C'oo,litjon or
rirja this,
M ModWIMM of Tunis aml C%ndhhns—No Umns and com%ms wNT Ran Own stowd Ascin.and
or undmotAnIng in any say pipirring to rnodify We man kw wmbdon M be
hrndin�) On Selkl-',vithoUt S01h'T"S wi-iLlen con,�,,,nL,
VOUCHER # 132933 WARRANT # ALLOWED
351017 IN SUM OF $
KIRBY RISK ELECTRICAL SUPPLY
PO BOX 664117
INDIANAPOLIS, IN 46266
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
1
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
S 107112613.Wi 01-6200-02 $119.23
si�176'23���< Uv� I� 57SD'00
Voucher Total $1 3
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
351017
KIRBY RISK ELECTRICAL SUPPLY Purchase Order No.
PO BOX 664117 Terms
INDIANAPOLIS, IN 46266 Due Date 10/1/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/1/2013 107112613.1 $119.23
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
Date Officer