245094 05/13/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 361104ONE CIVIC SQUARE CYBEX INTERNATIONAL INCCHECKAMOUNT: S*****"**75.31CARMEL, INDIANA 46032 PO BOX 8500-1401 CHECK NUMBER: 245094
PHILADELPHIA PA 19178-1401 CHECK DATE: 05/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4237000 1022167 75.31 REPAIR PARTS
4CYCYBEY Global Headquarters Remit to:
10 Trotter Drive Cybex International, Inc. INVOICE
Cybex International, Inc. Medway,MA 02053 P.O.Box 8500-1401
(508)533-4300 Philadelphia, PA 19178-1401 Page 1 of 1
(508)533-5500 fax United States
Sold To: Carmel Clay Parks&Recreation Ship To: Carmel Clay Parks&Recreation
1411 E. 116th St. 1235 Central Park Dr.E. Invoice Information
Carmel IN 46032 Monon center Invoice Date: Apr/29/2015
USA Attn.Mary Evans Invoice: 0001022167
Carmel IN 46032 Customer No: CYB0037634
USA
Payment Terms: Net 30
Bill To: Carmel Clay Parks&Recreation Due Date: May/29/2015
Carrie Keaveney AMOUNT DUE: 75.31 USD
1411 E. 116th St. r� + �
Carmel IN 46032 `
United States
MAY 04 2015 Shipment Information
>C3Y: Date Shipped: Apr/29/2015
_ Sales Order No: SVC0708116
Purchase Order No: XX-2033
Pro No: 1Z5638020354277660
~- — —- -- -- -— Carrier: United,Parcel Service;Inc. -
Ship Via: GROUND
Freight Terms: Prepaid
Line Product No. Description Quantity UOM Unit Amt Tax Net Amount
1 5420-029 Adjusting Bar Subassy 1.00 EA 67.81 N 67.81
2 OWTPRTFRT Shipping and Handling Charge 1.00 EA 7.50 N 7.50
Subtotal: 75.31
Subtotal (Sales/Use): 0.00
AMOUNT DUE: 75.31 USD
Order entered by Martin Stewart.Thank you for your order.
Buyer accepts and agrees to prices,specifications,standard terms&conditions of sale, including
warranty terms on this document,together with all the attachments hereto.
f
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.
361104 Cybex International, Inc. Terms
P.O. Box 8500-1401
Philiadelphia, PA 19178-1401
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
4/29/15 1022167 Cybex adjustable bar assembly xx2033 $ 75.31
Total $ 75.31
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
I
Voucher No. Warrant No.
361104 Cybex International, Inc. Allowed 20
P.O. Box 8500-1401
Philiadelphia, PA 19178-1401
In Sum of$
{
$ 75.31
I
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO kCCT#rrITLI AMOUNT Board Members
Dept#
1096-21 1022167 4237000 $ 75.31 1 iereby 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'
I.
May 7, 2015
Signature
$ 75.31 I Accounts Payable Coordinator .
Cost distribution ledger classification if ti Title
claim paid motor vehicle highway fund
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