225883 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 356915 Page 1 of 1
f, ONE CIVIC SQUARE L T RICH PRODUCTS INC
0 CHECK AMOUNT: $117.30
CARMEL, INDIANA 46032 920 HENDRICKS DR
LEBANON IN 46052 CHECK NUMBER: 225883
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 68952 117 . 30 REPAIR PARTS
Invoice 10/18/2013
LT Rich Products, Inc. 68952
LT Rich Products, Inc.
Lebanon, IN 46052
920 Hendricks Drive
Lebanon, IN 46052
Phone: 765-482-2040
Fax: 765-482-2050
Email: awalters @z-spray.com/rriley @z-spray.com
Bill To: Ship To:
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 WEST 131ST ST. 3400 WEST 131 ST ST.
CARMEL, IN 46074 CARMEL, IN 46074
Phone: 317-733-2001
Contact:CARMEL STREET DEPT.
Customer: CARMEL STREET DEPT.
Notes
will call
will call
will call
Seller Payment Terms FOB Point Carrier Ship Service Requested Ship Date
Scot DUE ON Origin Will Call 10118/2013
DELIVERY
Item Unit Qty
# Type Number/ Description Price Ordered Total Price
1 Sale 80519 - 15 HP CARBURETOR $ 113.94 1 ea $ 113.94
2 Sale 80520 -gasket, carb to intake $ 2.26 1 ea $2.26
3 Sale 80536 -GASKET, carb to breather 15HP 11061-7018 $ 1.10 1 ea $ 1.10
Subtotal: $ 117.30
Approval: I Date: Sales Tax: $ 0.00
QUOTES E .PI �H 30 DAYS FROM ISSUE DATE! Total: $ 117.30
October 18,2013 2:05:50 PM EDT Page 1 of 1
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))
10/18/13 68952 $117.30
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
LT Rich Products Inc
IN SUM OF $
920 Hendricks Drive
Lebanon, IN 46052
$117.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 I 68952 I 42-370.001 $117.:30 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
Thu ay, c ber 31, 2013
Street Commissio e
Atrpat Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund