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244981 05/05/15 (;i s CITY OF CARMEL, INDIANA VENDOR: 264001 t, CHECK AMOUNT: $*******1 13.99* ,. ONE CIVIC SQUARE RED WING SHOE STORES INC ?� CARMEL, INDIANA 46032 6653 E 82ND ST CHECK NUMBER: 244981 INDPLS IN 46250 CHECK DATE: 05/05/15 (TON GO• DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4356003 6060 113.99 SAFETY ACCESSORIES Original Invoice BILL TO- REMIT TO- ATTN: AMY LUNN Red Wing Shoe Store CITY OF CARMEL STREET DEPT 6653 East 82nd St. 3400 W 131ST ST Castleton Village CARMEL,IN 46074 Indianapolis,IN 46250-4577 (317)577-0760 Invoice Number Invoice Date Terms Description 510000006060 04/22/2015 Net 30 'Ticket#- -- Date Purchased By - Otherinformation - Item" - "- -"" "Amount - 00051052644 03/25/2015 COFFEY,TIM Employee#:2285 05009W2130 113.99 Total $113.99 Net Total $113.99 Total Merch $113.99 Customer Tax $0.00 Maj.Acct.Tax $0.00 Message: Total Charges $113.99 Customer Payment $0.00 Maj.Acct.Payment $0.00 Total Due $113.99 Date Due 05/22/2015 1 i VOUCHER NO. WARRANT NO. ALLOWED 20 Red Wing Shoe Store IN SUM OF$ 6653 E. 82nd Street Indianapolis, IN 46250-4577 $113.99 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members. 2201 510000006060 43-560.03 $113.99 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 R 0 All y Th),r day ril 30, 0 5 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)) 04/22/15 510000006060 $113.99 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