227384 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 363327 Page 1 of 1
ONE CIVIC SQUARE HILTI INC
/ CHECK AMOUNT: $196.38
CARMEL, INDIANA 46032 PO BOX 382002
PITTSBURGH PA 15250 CHECK NUMBER: 227384
CHECK DATE: 12117/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4603463033 196 . 38 OTHER EXPENSES
3 G-3 J,�l Page 1(1)
ORIGINAL INVOICE
I;; rk INVOICE NUMBER: 4603463033
INVOICE DATE: 11/27/2013
CUSTOMER P.O. NUMBER:
S13794 DUNS: 00-117-3525
CUSTOMER ACCT: 13328080
FEDERAL ID: 06-0732334
1661951128 0 000792 000792 01/01 001 Delivery Address:
II1111111 II 1111 II 11111111111111111111111
CARMEL CITY OF
CARMEL*CITY OF
* 9609 HAZEL DELL PKWY
I.rfk UTILITIES/WATER UTILITY INDIANAPOLIS IN 46280-2935
3450 W 131ST ST ATTN:ROB LOVELL
t � WESTFIELD IN 46074-8267 317-716-3917
951
HILTI SALES REP: RAY PHILLIPS,TUS0511711 ORDER NUMBER: 515785813
PAYMENT TERMS: _ 30 DAYS NET LOCATION ID: 21207342
- ^^TT� . -1a.
IIYV VICL�UL VI"11� JJr�l2�l�itO1�J "'- -' --'----' --- -- -I-
SHIPMENT NUMBER APPEARS ON PACKING SLIP(S). USE TO MATCH ALL DOCUMENTS AND CONFIRM RECEIPT.
Material Material Description :- -Quantity. ,.Quantity Shipped Sell Price- Amount Due
Number Invoiced
SHIPMENT NUMBER:394666567
3498242 HDM 500MANUAL DISPENSER+RED 1 EA 101.98 101.98 B
2005641 MANUAL ADHESIVE DISPENSE 1 EA
2007059 RED CARTRIDGE HIT-CR 500 1 EA
2022791 HIT-HY 200-A 11.1 FL OZ/330ML 2 EA 2 EA 38.00 76.00 B
FREIGHT
12.00
FREIGHT FUEL SURCHARGE 6.40
Taxes: State: IN 0.00% $ 0.00 County: 0.00% $ 0.00 City: 0.00% $ 0.00
* A-Taxable B-Non-Taxable C-Limited Shelf Life D-Non-Domestic Source E-Non-Domestic Source NATO Exception
SUB TOTAL -:;: TOTAL TAX° TOTAL AMOUNT USD ;
$196.38 $0.00 $196.38
Product Sales: 800-879-8000 Hilti Credit Dept: 800-950-6196 Mail all written inquiries to Hilti Hilti Delivery Policy: www.us.hilb.comitransportation Fax certificate to Tax Dept or mail with
Website: www.us.hilti.com Hilli Credit Fax: 918-252-3810 PO Box 21148 Tulsa,OK 74121-1148 Hilti Tax Fax: 800-950-6605 payment to remit to address
CUSTOMER ;=INVOICE �0NVOICE DATE PREPAYMENT AMOUNT DUE ,(USD); PAYMENT �.
A000UNT - � ENCL`OSED.. .
13328080 146034630331 11/27/2013 $196.38 ,tea
BILL TO: CARMEL*CITY OF Delivery Address: CARMEL* CITY OF
UTILITIESNVATER UTILITY 9609 HAZEL DELL PKWY
3450
W
WES TFIEL ST ST
INDIANAPOLIS IN 46280-2935
WES
ELD IN 46074-8267
ATTN: ROB LOVELL
317-716-3917
Please make checks payable to Hilti and remit in USD. HILTI INC.
A fee of$25.00 is assessed for return checks. I REMIT TO �
Material returns after 90 days are subject to a$125 = PO BOX 382002
restocking fee.Chemicals returnable within 14 days PITTSBURGH PA 15250-8002
by the case only.Standard Hilti terms and conditions
apply.Visit www.us.hilb.com/terms for full terms.
In�Il�l�l�nl�l�l�l�llu�l»I�Il�nllnn�l�ll���ll
1 13328080 4603463033 11272013 0000019638
VOUCHER # 137041 WARRANT # ALLOWED
363327 IN SUM OF $
HILTI INC.
PO BOX 382002 !
PITTSBURGH, PA 15250-8002
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
4603463033 01-7202-06 $196.38
i
i
1
Voucher Total $196.38
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
363327
HILTI INC. Purchase Order No.
PO BOX 382002 Terms
PITTSBURGH, PA 15250-8002 Due Date 12/11/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/11/201, 4603463033 $196.38
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