HomeMy WebLinkAbout236172 08/19/14 ,+ '`""*F CITY OF CARMEL, INDIANA VENDOR: 366478
ONE CIVIC SQUARE FREDERICK MARTZ CHECK AMOUNT: $*******162.99*
,� CARMEL, INDIANA 46032 3340 GIFFORD AVE CHECK NUMBER: 236172
°M,��oN-�o• CICERO IN 46034 CHECK DATE: 08/19/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356003 162.99 SAFETY ACCESSORIES
Printable Receipt For Your Records
WWW.BOOTBAY.COM
ORDER#P07113477
Ship FRED MARTZ sill FRED MARTZ
To: 3340 GIFFORD AVE To: 3340 GIFFORD AVE
CICERO, IN 46034 CICERO, IN 46034
USA USA
317-508-7973 317-508-7973
MART116@YAHOO.COM MARTI 16@YAHOO.COM
Order Date: 05/28/2014
PAID IN FULL WITH A MONEY ORDER
Item# Description Qty Reg. Your Total
Price Price
6717 Rocky Men's Ride Safety 1 $184.95 $162.99 $162.99
11.5 Lacers - Bridle
w
• 10.25" Leather Shaft
• Full Length Cushion Sock Lining
• YKKA®Locking Inside Zipper
• GoodyearA®Welt Construction
• Rubber Outsole
• 1.5"Heel
Subtotal: $162.99
Shipping: $0.00
Tax: $0.00
TOTAL: $162.99
Home Print this nage My Order History
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POSTAL
POSTdSTdTES
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EE BACK OF THIS RECEIPT pay to KEEP THIS
FOR IMPORTANT CLAIM RECEIPT FOR
INFORMATION
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NEGOTIABLE �. � �,_pgczd-4,
Serial Number Year,Morttli DaY Post Office Artwunt Qerk
215626 226? 2014-05-22 460690 $162.
SerW Number Yea Month,Day Past Office LLS Dollars and Cents
215 6 262 2 2 6? :: ` ' 2014-05-zn 4606902
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Fred Martz
IN SUM OF$
c/o Carmel Street Department
$162.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I I 43-560.031 $162.99 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
i 2014
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/28/14 $162.99
I
I
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
, 20
Clerk-Treasurer