227139 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 316200 Page 1 of 1
ONE CIVIC SQUARE UTILITY SUPPLY CO INC. CHECK AMOUNT: $149.82
� o CARMEL, INDIANA 46032 6310 S HARDING ST
INDIANAPOLIS IN 46217 CHECK NUMBER: 227139
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1111319 149 . 82 OTHER EXPENSES
INV®ICE
UTILITY SUPPLY COMPANY
Branch: 03 USC NW INDY _ INVOICE
1111319
6310 SOUTH HARDING STREET -- —
INDIANAPOLIS,IN 46217 Invoice Date F Page
US 11/26/2013 15_IT 37 1 of 1
ORDER NUMBER
317-783-4196 1118399
Bill To: Ship To:
CARMEL WATER DISTRIBUTION CARMEL WATER DISTRIBUTION
3450 WEST 131ST STREET 3450 WEST 131ST STREET
CARMEL,IN 46074 CARMEL,IN 46074
US US
Attn:K LOVEALL Ordered By'.GREG HOLLANDER
Customer ID: 100753
PO Number Tenn Description Net Due Date Disc Due Date Discount Amount
GH-11/2512013 1435:43 Net 30 DAYS 12/26/2013 12/26/2013 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
11/25/2013 14:35:16 1121451 ANDY NUGENT ZSTIERWALT
Quantities Pricing
Item ID UOAI Unit Extended
UOM c Item Description Price Price
Orderer( Shipper( Remaining Unit Size q Unit Size
Carrier: OUR TRUCK Tracking#:
2.00 3.00 0.00 EA 226-069007-000 EA 49.9412 149.82
1.0 6 X 7-1/2 SMITH BLAIR 684-724 1.0000
REPAIR CLAMP
Total Lines: I SUB-TOTAL: 149.82
TAX: 0.00
A FINANCE CHARGE computed at a periodic rate of 1 1/2%per month(18% AMOUNT DUE: 149.82
ANNUAL PERCENTAGE RATE)is applied to PAST DUE ACCOUNTS OVER 30 DAYS.
- ORIGINAL
l
t
VOUCHER # 133520 WARRANT # ALLOWED
316200 IN SUM OF $
Utility Supply Company
6310 South Harding Street
Indianapolis, IN 46217
i
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
I
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1111319 01-6200-06 $149.82
I
1
f
1
i
Voucher Total $149.82
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
316200
Utility Supply Company Purchase Order No.
6310 South Harding Street Terms
Indianapolis, IN 46217 Due Date 12/5/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/5/2013 1111319 $149.82
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