226997 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 359478 Page 1 of 1
ONE CIVIC SQUARE HILLYARD/INDIANA CHECK AMOUNT: $558.07
CARMEL, INDIANA 46032 P 0 BOX 872361
KANSAS CITY MO 64187-2361 CHECK NUMBER: 226997
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 600936095 558 . 07 OTHER EXPENSES
PLEASE DETACH AT THE PERFORATION ABOVE AND RETURN THE STUB WITH YOUR PAYMENT.IT WILL INSURE PROPER CREDITING TO YOUR ACCOUNT.
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ITEM MATERIAL DESCRIPTION QUANTITY UNIT PRICE AMOUNT
oolo LR4348150K 2 CS 43.14 86.28
LINER 56GAL 43X48 1.5MIL BLK 100/CS PAYL
0020 HIL0103954 24 EA 2.87 68.88
GERMICIDAL FOAMING CLEANER 20 OZ
0030 HIL0014406 4 GAL 7.74 30.96
TOP CLEAN
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0040 PAP10110 2 CS 48.86 97.72
TOWEL ROLL GSC NAT WHT CONTROL 6 800 CS
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0050 PG53971 3 CS 54.41 163.23
TOWEL BOUNTY 30 RLS
0060 PAP38110 2 CS 48.00 96.00
TISSUE PREM OPTICORE 2 PLY 36 800 CS I
0070 PAP42500 1 EA
DISP HANDS FREE BATTERY BLACK TRANS
Subtotal 543.07
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Shipping 15.00
Tax Amount 0.00
Gross Price 558.07
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Invoice Number 600936095 Date 11/20/2013 Purchase Order:BLAINE MALLABER
Plant: 1350 Customer Number 272994 CARMEL W.W.T.P. -WASTEWATER UTILIT
HILLYARD HILL YARD/INDIANA Invoice
P. O. Box:872361 Invoice
THE CLEANING RESOURCE' Kansas City, MO 64187-2361 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.
VOUCHER # 136978 WARRANT # ALLOWED
359478 IN SUM OF $
HILLYARD/INDIANA
PO BOX 872361
KANSAS CITY, MO 64187-2361
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR j
}Y
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Board members
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PO# INV# ACCT# AMOUNT Audit Trail Code
600936095 01-7202-05 $558.07
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Voucher Total $558.07
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
359478
HILLYARD/INDIANA Purchase Order No.
PO BOX 872361 Terms
KANSAS CITY, MO 64187-2361 Due Date 12/5/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/5/2013 600936095 $558.07
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