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Home My WebLink About246329 06/17/15 CITY OF CARMEL, INDIANA VENDOR: 369486 ® ONE CIVIC SQUARE LISTON HALEY CHECK AMOUNT: $"``*****`6.00` CARMEL, INDIANA 46032 16402 CAREY ROAD CHECK NUMBER: 246329 M_roN`o, WESTFIELD IN 46074 CHECK DATE: 06/17/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4358400 S1264924 6.00 REFUNDS AWARDS & INDE Carmel e Clay Parks&Recreation CHECK REQUEST Date: June 8,2015fic-JUN 9 2015 f I - Check payable to: � Name: Haley Liston Address: 16402 Caret/Road City,State,Zip Westfield, IN 46074 XK Mail check to payee Return check to requestor Check Amount:$ 6.00 Date Required: Next cycle Purpose of Check: Refund CCPR staff member for overpayment on uniform purchase. Owed$34.50 and paid$40.00 cash per attached order form. Supporting documentation or invoice(s)MUST be attached. To be paid from: PO#(if applicable) n/a Budget account-GL# 1091-4358400 Budget Line Description MCC Admin-Refunds Requested by(print): Audrey Kostrzewa Requested by(signature/date): Approved by(print): Audrey Kostrzewa / Approved by(signature/date) Form recreated 3/10/15(Business Services) Carmel 0 oda _- Parks&Recrea$0® Date:�yJ ��U�� PURCHASE - UNIFORM ORDER FORM EMPLOYEE PU ,}-�\ 2015 Employee Name: H� LI C SJ \ v n - Employees may order any time throughout the year. ' Samples are available at the Admin Office for sizing. �C,��r. ,1 ()1 NO REFUNDS OR EXCHANGES. Check or exact change only. Position: Questions] Dawn Koepper,573-4026 Item Type circle one Size circle one Qty Price Total S M LXL $14.50 2XL 2XL-$16.00 Shirt,polo,Option 1 Men's Women's 3XL 3XL-$17.00 4XL 4XL-$18.00 S M LXL $16.00 Shirt.polo.Option 2(Professional) Men's Women's 2XL 2XL-$17.50 3XL 3XL-$18.50 4XL 4XL-$19.50 S M LXL $19.00 Shirt.polo,Outdoor Dry Fit Navy Men's Women's 2XL 2XI-420.00 II 3XL 3XL-$21.00 4XL 4XL-$22.00 S M LXL $19.00 Shirt,polo.Outdoor Dry Fit Red Men's Women's 2XL 2XL-$20.00 (Aquatics Only) 3XL 3XL-$21.00 4XL 4XL-$22.00 S M LXL $500 2XL 2XL-$6:00 Shirt.Blue Tee Short Sleeve Unisex 3XL 3XL-$7.00 4XL 4XL-$8.00 S M LXL $8.00 Shirt Blue Tee Long Sleeve Unisex 2XL 2XL-$9.00 3XL 3XL-$10.00 4XL 4XL-$11.00 S M LXL $21.50 Shirt,Oxford,long-sleeve,blue futon's Women's 2XL 2XL-$22.503XL 3XL-$23.50 4XL 4XL-$24.50 S M LXL $20.00 Vest,fleece Unisex 2XL 2XL-$21.50 3XL 3XL-$22.50 4XL 4XL-$23.50 Women s(XS-2XL) XS S M L $28.00 Sweater,Women's Cardigan XL 2XL 2XL-$29.00 XS S M L $21.50 Sweater,Men's V-Neck Men's(S-2XL) 2XL-527.50 XL 2XL 3XL 3XL-$28.50 Men's(S-3XL) XS S M L 524.00 Jacket,fleece 2XL-525.00 Women's(XS-3XL) XL 2XL 3XL 3XL-$26 00 X L 4 Jacket,rain Men's 42ED 2XL-$36.00 XL 2XL 3XL 3XL-$37.00 XS S M L $52.50 Jacket,soft shell Men's Women's 2XL-$54.50 XL 2XL 3XL 3XL-$56.50 Hat.ski cap Unisex NIA $6.00 Hat,ball cap.khaki Unisex NIA $8.50 Head Band Unisex NIA 54.00 Visor Unisex NIA $8.50 Item Total $ JY Payment Type: Check#__ Cash _ ' /uX +7%Sales Tax Included in Unit Price Accepted by: Total Purchase $ Date: I Rzc-/- -UI V-D 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. Haley, Liston Terms 16402 Carey Road Westfield, IN 46074 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 6/8/15 Reimb Refund of overpayment on uniform order $ 6.00 Total $ 6.00 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. Haley, Liston Allowed 20 16402 Carey Road Westfield, IN 46074 In Sum of$ $ 6.00 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 Reimb 4358400 $ 6.00 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 June 11, 2015 Signature $ 6.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund