HomeMy WebLinkAbout228817 1/29/2014 q,f CITY OF CARMEL, INDIANA VENDOR: 356009 Page 1 of 1
ONE CIVIC SQUARE R G A/HOOSIER RUBBER&TRANSMISS6HECK AMOUNT: $78.00
4 ,?o CARMEL, INDIANA 46032 3905 EAST PROGRESS STREET
yCroM to�... NORTH LITTLE ROCK AR 72114 CHECK NUMBER: 228817
CHECK DATE: 1/29/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 F84236-001 78 . 00 OTHER EXPENSES
INVOICE
MAIL REMITTANCE TO: ENTERING OFFICE INVOICE NUMBER TRAIN
CODE
RGA F84236-001 DI
RGA 2002 LAFAYETTE RD INVOICE DATE PAGE
INDIANAPOLIS IN 46222 12/27/13 1
AN EMPLOYEE OWNED COMPANY
3905 East Progress Street
Any different or additional terms that may be embodied in your purchase order are hereby objected to. If your order is not an
North Little Rock, AR 721 14 acceptance of our proposal,this will operate as an acceptance of your order only in the event you agree to the terms hereof.
The terms and conditions contained above and attached shall apply.
QUAN7tTY
LINE: PART NUN1i3Elt UPFIT OP:INI ASURf UNfT PRfCEXTENDffI)
TOTAI BACK:: THIS
N� RD HIP N# t?ESGRiPT10N FHppUCT AESCUUfdT Q!o AMOUNT
10 24 24 SHTR-GASKET-EA 1 ,9500 46.80
400-G-BU SHTR EA
50 12 12 SHTR-GASKET-EA 1 . 1000 13.20
300-G-BU SHTR EA
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FOLD
CUST.NO, ORDER DATE TERR PC ORD Written By DATE SHIPPED WHSE AMOUNT 60.00 i
TC125- -12/-19;-13 TD 70 S TJS 12/27/13 70
FRGHT/INS/HNDL 18.00
Carrier: UPS FOB: SP,FNA,PREPAID ORIGINAL INVOICE
Tracking:. _ SALES TAX 00 i
Terms of Payment: NET 30 DAYS INVOICE TOTAL 78.00
Please Pay This Amount i
ORDER ISSUED IN: INDIANAPOLIS
Note New Remit To Address: PHONE: 317/634-3976
3905 East Progress Street
North Little Rock, AR 72114
Customer PO No. GODWIN PUMP Mark No. JEFF 716-5882
s CARMEL UTILITIES s CARMEL WASTE WATER
0 760 3RD AVENUE SW H 9609 HAZEL DELL PARKWAY
D SUITE 110 P
T CARMEL IN 46032 T INDIANAPOLIS IN 46280
0 0
VOUCHER # 137226 WARRANT # ALLOWED
350590 IN SUM OF $
RGA/HOOSIER RUBBER & TRANSMIS!
3905 E. Progress Street
North Little Rock, AR 72114
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
I
F84236-001 01-7202-06 $78.00 `
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Voucher Total $78.00
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
350590
RGA/HOOSIER RUBBER &TRANSMISSON Purchase Order No.
3905 E. Progress Street Terms
North Little Rock, AR 72114 Due Date 12/30/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201: F84236-001 $78.00
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
12 q-
Date Officer