225841 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 359478 Page 1 of 1
f ONE CIVIC SQUARE HILLYARD/INDIANA
CARMEL, INDIANA 46032 P 0 BOX 872361 CHECK AMOUNT: $64.97
? KANSAS CITY MO 64187-2361
CHECK NUMBER: 225841
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4238900 600897116 64 . 97 OTHER MAINT SUPPLIES
www.hillyard.com
Remit To:
HILLYARD
HILL YARD/INDIANA .......
..,
n orma ion:; :
NOONNON
P.O Box:872361 Customer Number: 256298
Tff CLEAMNG RESOURCE® Kansas City, MO 64187-2361
Invoice Number 6008971 16
Plant: 1350
Phone: 765 378 3766 2 Invoice Date 10/21/2013
Fax: 7653786671 J Purchase Order No. ISA-10/17/2013
12- Packing List Number 85822891
Ship CITY OF CARMEL
To ATTN: JEFF BARNES Sales Order Number 21 292995
ONE CIVIC SQUARE Payment Terms Net due in 30 days
CARMEL IN 46032
1111111 Hil 1111I 11111111 IIII 111111111IIIIIIII 111 Page 1 of 1
BIII CITY OF CARMEL 600897116
To ATTN: JEFF BARNES
ONE CIVIC SQUARE
CARMEL IN 46032 Total:Amount<;_ue...........:6
PLEASE DETACH AT THE PERFORATION ABOVE AND RETURN THE STUB WITH YOUR PAYMENT.IT WILL INSURE PROPER CREDITING TO YOUR ACCOUNT.
ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT
0010 HIL30412 10 PAC 6.28 62.80
GLOVE NITRILE PWDR FREE LARGE 100 BOX
Subtotal 62.80
Shipping 2.17
Tax Amount 0.00
-------------
- Gross Price 64.97
D i
NOV 4 2013
I
B _
Invoice Number 600897116 Date 10/21/2013 Purchase Order:ISA-10/17/2013
Plant: 1350 Customer Number 256298 CITY OF CARMEL
HILLYARD HILL YARD/INDIANA Invoice
a r. c P. O. Box:872361
TE�CLEANINGRESOURCE' Kansas City, MO 64187-2367 CUSTOMER COPY THANK YOU!
THE SELLER REPRESENTS IT HAS FULLY COMPLIED WITH THE PROVISIONS OF THE FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED,IN THE MANUFACTURE OF GOODS COVERED BY 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 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))
10/21/13 600897116 $64.97
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
Hillyard / Indiana ALLOWED 20
IN SUM OF$
PO Box 872361
Kansas City, MO 64187-2361
$64.97
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1205 I 600897116 I 42-389.00 I $64.97 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
Monday, November 04, 2013
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund