HomeMy WebLinkAbout236046 08/13/14 �'4�p" CITY OF CARMEL, INDIANA VENDOR: 367794
{ ® ONE CIVIC SQUARE TAKEFORM CHECK AMOUNT: S•"""""`257.49•
:9 _ CARMEL, INDIANA 46032 11601 MAPLE RIDGE ROAD CHECK NUMBER: 236046
,�'��rON�°, MEDINA NY 14103 CHECK DATE: 08/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4239099 40007 27.74 OTHER MISCELLANOUS
1093 4239099 40007 229.75 OTHER MISCELLANOUS
Invoice#: 40007
11601 Maple Ridge Road t' r ,
' Invoice Date: 7/3/14
Medina, NY 14103
0_0 800-528-1398 JUL 10 2014 PO#: XX-799 XX-804
Payment Terms: Net 30
Bill To: Carmel Clay Parks & Recreation Ph: (317) 573-4026
Fax: (317) 571-4136
Attn: Dawn Koepper Email: dkoepper@carmelclayparks.com
1411 E. 116th Street
Carmel, IN 46032
Job Name: CAR0061: Monon Community Center
Unit Net -Net
Line Description ���5ry� �� R/ Mf�'i� Quantity- —price --Price-Ext
1 Type M: Flag Mount ID F55D-BA-F V(00+ to93- qmn 1 229.75 229.75
2 Type L.2: Workstation ID X)C 74q Nom fi t& 1 27.74 27.74
l09 µZ39099
Net Total: $257.49
Balance Due(USD): $257.49
Terms are Net 30. Past due accounts are subject to 1% interest per month. We reserve the right to hold future orders or
ship future orders COD if terms are not adhered to. Purchaser is responsible for all fees and expenses including but not
limited to, attorneys and collection fees incurred by Takeform in the enforcement of this agreement.
Credit cards accepted. Please complete form below and fax to Accounts Receivable at 585-798-8889
Payment Options: Carmel Clay Parks&Recreation
Visa MasterCard Discover American Express Invoice #
Balance Due: $257.49
Cardholder's Name:
Card Number: C V V 2#:
Expiration Date:
Card Billing Address:
Signature:
Print Date:7/3/2014 4:42:26PM Page 1 of 1
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.
367794 Takeform Terms
11601 Maple Ridge Road
Medina, NY 14103
Invoice Invoice Description
Date Number (or note attached invoices)or bill(s)) PO# Amount
7/3/14 40007 Flag style sign replacement xx804 $. 229.75
7/3/14 40007 Nameplate -,ia7Q9:. $ _=_ 27:74: -
Total $ 257.49
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
Voucher No. Warrant No. 4
I
367794 Takeform Allowed 20
11601 Maple Ridge Road i
Medina, NY 14103
In Sum of$
$ 257.49
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
I
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1093 40007 4239099 $ 229.75 1 hereby certify that the attached invoice(s), or
1091 40007 4239099 $ 27.74 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
f
i
7-Aug 2014
I
i
I
Signature
$ 257.49_ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund