225404 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 359478 Page 1 of 1
ONE CIVIC SQUARE HILLYARD/INDIANA CHECK AMOUNT: $478.37
CARMEL, INDIANA 46032 P O BOX 872361
KANSAS CITY MO 64187-2361 CHECK NUMBER: 225404
CHECK DATE: 1012312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 272994 478 . 37 OTHER EXPENSES
1
Remit TO:
HILLYARD *uLYARD/INDIANA
NVOONONIIIE P.o Box:orz3n/ Customer Number: 272994
THE CnAxNC RESOURCE= Kansas City, xvn 64187'2361 Invoice Number 600883740
Plant: 1350
Phone: 765 378 3766 Invoice Date 10/09/2013
Fax: 7653786671 Purchase Order No. BLAINE MALLABER
Packing List Number 85812341
Ship CARMELVV.VV.T.P. WASTEWATER UT|L|T
To S609 HAZEL DELL PARKWAY Sales Order Number 39195369
INDIANAPOLIS IN 40280 Payment Terms Net due in 30 days
Page 1 of 1
Bill CARW1ELUT|L|T|ES 600883740
T0 L|SAKEK4PA
780 THIRD AVENUE SVV SUITE 110
CARK8EL |N 48032
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PLEASE DETACH^zTxEpEoro*zmwAoovE Awoo�uhwn*som^ .nHvoux»^YMEwrnwuL/wooxsroop«xcncomwennvooxAc000wr |
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ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT
0010 LR4348150K I CS 40.91 40.91
0020 PAP38110 2 CS 48.00 96.00
TISSUE PREM OPTICORE 2 PLY 36 800 CS
0030 PG53971 6 CS 54.41 326.46
TOWEL BOUNTY 30 RLS
Subtotal 463.37
Shipping 15.00
Tax Amount 0.00
Gross Price 478.37
Invoice Number 600883740 DatelO/09/2013 Purchase Order:BLAINE MALLABER
Plant: 1350 Customer Number 272994--C-PiRMEL W.W.T.P. --WASTEWATER I-ITILIT
HILLYARD HILL YARD/INDIANA Invoice
zc04XM P. 0. Box:872361
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THE SELLER REPRESENTS n HAS FULLY COMPLIED WITH THE PROVISIONS m THE FAIR LABOR STANDARDS ACT m.�w AMENDED,�THE MANUFACTURE�GOODS COVERED�THIS INVOICE. __
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
359478
HILLYARD/INDIANA Purchase Order No.
PO BOX 872361 Terms
KANSAS CITY, MO 64187-2361 Due Date 10/17/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/17/201: 272994 $478.37
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
VOUCHER # 136643 WARRANT # ALLOWED
359478 IN SUM OF $
HILLYARD/INDIANA
PO BOX 872361
KANSAS CITY, MO 64187-2361
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
272994 01-7202-05 $478.37
Voucher Total $478.37
Cost distribution ledger classification if
claim paid under vehicle highway fund