246519 06/17/15 CITY OF CARMEL, INDIANA VENDOR: 369495
ONE CIVIC SQUARE DANIEL RUESCH CHECK AMOUNT: $*********2.42*
r CARMEL, INDIANA 46032 10940 TIMBER LANE CHECK NUMBER: 246519
CARMEL IN 46032 CHECK DATE: 06/17/15
tON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4358400 2,42 REFUNDS AWARDS & INDE
Carmel e Clay
Parks&Recreation CHECK REQUEST
Date: June 8,2015 JUN - 9 2015
Check payable to:
Name: Daniel Ruesch
Address: 10940 Timber Lane
City,State,Zip Carmel,IN 46032
XX Mail check to payee Return check to requestor
Check Amount:$ 2.42 Date Required: Next cycle
Purpose of Check: Refund CCPR staff member for overpayment on uniform purchase.
Owed$34.50 and paid$36.92 by check 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): G�
Approved by(print): Audrey Kostrzewa / /
Approved by(signature/date) i o �l ? l
Form recreated 3/10/15(Business Services)
Carmel ® Clay
Pa -ks�Recreation
Date:
EMPLOYEE PURCHASE•UNIFORM ORDER FORM P<Ve_SCk2015 Employee Name: _�ari)e'1
Employees may order any time throughout the year. +
Samples are available at the Admin Office for sizing.
NO REFUNDS OR EXCHANGES. Check or exact change only, Position:
Questions? Dawn Koepper,573-4026
Item Type circle one Size circle one . City Price Total
S M L XL $14.50
Shirt,polo,Option 1 Men's Women's 2XL 2XL-$16.003XL 3XL-$17.00
4XL 4XL-$18.00
S M L XL $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 L XL $19.00
Shirt,polo,Outdoor Dry Fit Navy Men's Women's 2XL 2XL-$20.00
3XL 3XL-$21.00
4XL 4XL-$22.00
S M L XL . $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 L XL $5.00
Shirt;Blue Tee Short Sleeve Unisex 2XL 2XL-$6.003XL 3XL-$7.00
4XL 4XL-$8.00
S M L XL $8.00
Shirt,Blue Tee Long Sleeve Unisex 2XL 2XL-$9.00
3XL 3XL-$10.00
4XL 4XL-$11.00
S M L XL $21.50
Shirt,Oxford,long-sleeve,blue Men's Women's 2XL 2XL-$22.50
3XL 3XL-$23.50
4XL 4XL-$24.50
S M L XL $20.00
Vest,fleece Unisex 2XL 2XL-$21.50
3XL 3XL-$22.50
01. 0023.50
Sweater,Women's Cardigan Women's(XS-2XL) XS S M L $28.00
XL 2XL 2XL-$29.00
XS S M L $21.50
Sweater,Men's V-Neck Men's(S-2XL) 2XL-$27.50
XL 2XL 3XL 3XL-$28.50
Men's(5-3XL) XS 5 97 $24.00
Jacket,fleece 2XL-$25.00
Women's(XS-3XL) XL 2XL 3XL 3XL-$26.00
XS SL5 L $34.50 A
Jacket,rain Men's Women's 2XL-$36.00 3,115(�
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 $4.00
visor Unisex NIA $8.50
2j� Item Total $
Payment Type: Check N Cash
+7%Sales Tax Included in Unit Price d
Accepted by: _
Date:
(� �s Total Purchase Z ; 7T0
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.
Ruesch, Daniel Terms
10940 Timber Lane
Carmel, IN 46032
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 $ 2.42
Total $ 2.42
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.
Ruesch, Daniel Allowed 20
10940 Timber Lane
Carmel, IN 46032
In Sum of$
$ 2.42
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#ITITLE AMOUNT Board Members
Dept#
1091 Reimb 4358400 $ 2.42 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
'P
' Signature
$ 2.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I