234049 06/25/14 Q
CITY OF CARMEL, INDIANA VENDOR: 364209
ONE CIVIC SQUARE JOHNSON HEALTH TECH NA INC CHECK AMOUNT: S•"'"•"'144.41CARMEL, INDIANA 46032 1600 LANDMARK DRIVE CHECK NUMBER: 234049
COTTAGE GROVE WI 53527 CHECK DATE: 06/25/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4237000 9001379535 144.41 REPAIR PARTS
Johnson Health Tech NA Inc. INVOICE
1600 Landmark Drive Document 9001379535
Cottage Grove,WI 53527
JOHNSON Phone:608-839-1240 Date 02/08/2014
Fax:608-839-1260 Page 1 of 1
***REPRINT***
Bill-To:33004423 Ship-To:33004423
Carmel Clay Parks and Recreation Clay Park and Rec-Carmel
Collene Broderick Kurtis Baumgartner
1411 E 116th Street 1235 Central Park Dr E
Carmel,IN 46032 Carmel,IN 46032
Comment: CRM User:John Schuepbach;CRM Order#:ORD-731540;Case#:CAS-623190 BPXT1 D;CAS-623190-BPXT1 D
Shipping Comment: - - - _ - --- -
Purchase Order No. Sales Order No. Sales Person ID Shipping Method Terms Due Date
XX-193 100828749 GLTM(GreatLakes-TM) UPS GROUND 100%PTS 02/08/2014
LN# Qty. Model Number Item Number Description List Price Net Unit Price Ext.Price
10 5 0000093285 Digital Dispatch Roll Wire;800L;RJ45;TV0 26.96 134.80
I
Kurds qX s
XXlg3 ono
Cl 21 �a
Remit To: Discounts mo Freight 9.61
Johnson Health Tech NA Inc. Misc./Duty o.00 Freight Disc. 0.00
1600 Landmark Drive Other Fees o.0o Tax 0.00,
Cottage Grove,WI 53527Subtotal 134.80 `T40 USD 1 4!
A Service Charge of 1.5%Per Month
Will Apply To All Delinquent Balances VVISION
M' HofV'ZON M nT IZ 1 X
�� FITNESS F I T N E S S
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
364209 Johnson Health Tech NA, Inc. Terms
1600 Landmark Drive
Cottage Grove, VW 53527
Invoice Invoice Description
Date Number - (or note attached invoice(s)or bill(s)) PO# Amount
2/8/14 9001379535 Chords for Matrix TVs xx193 $ 144.41
Total $ 144.41
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
. i
Voucher No. Warrant No.
364,209 Johnson Health Tech NA, Inc. i Allowed 20
1600 Landmark Drive
Cottage Grove,W 53527
In Sum of$
$ 144.41
ON ACCOUNT OF APPROPRIATION FOR
I
109 -Monon Center
PO#or.- INVOICE NO. ACCT#/TITLE AMOUNT i Board Members
Dept#
1096-21 9001379535 4237000 $ 144.41 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
19-Jun 2014
I
i
Signature
$ 144.41 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I