247454 07/15/15I%
CITY OF CARMEL, INDIANA VENDOR: 264001
® it ONE CIVIC SQUARE RED WING SHOE STORES INC CHECK AMOUNT: $ """*150.00`
i•. ,a� CARMEL, INDIANA 46032 6653 E 82ND ST CHECK NUMBER: 247454
INDPLS IN 46250 CHECK DATE: 07/15/15
4�u
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 51000000621 150.00 OTHER EXPENSES
i
Original Invoice
BILL TO- REMIT TO-
ATTN: KERRI LOVEALL Red Wing Shoe Store
CITY OF CARMEL UTILITIES/WATER 6653 East 82nd St.
3450 W. 131ST ST. Castleton Village
CARMEL,IN 46074 Indianapolis,IN 46250-4577
(317)577-0760
Invoice Number Invoice Date Terms Description
510000006219 06/24/2015 Net 30
Ticket# Date Purchased By Other Information Item Amount
00051053857 06/19/2015 HAYMAKER,BRAD PO#:515226 83912D 115 189.99
Customer Tax 2.80
Total $192.79
Customer Payment $42.79
Net Total $150.00
Total Merch $189.99
Customer Tax $2.80
Maj.Acct.Tax $0.00
Message: Total Charges $192.79
Customer Payment $42.79
Maj.Acct.Payment $0.00
Total Due $150.00
Date Due 07/24/2015
1
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
264001
RED WING SHOE STORES INC Purchase Order No.
6653 E. 82ND STREET Terms
INDIANAPOLIS, IN 46250 Due Date 7/8/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/8/2015 5100000062' $150.00
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
Date Officer
VOUCHER # 155874 WARRANT # ALLOWED
264001 IN SUM OF $
RED WING SHOE STORES INC
6653 E. 82ND STREET
INDIANAPOLIS, IN 46250
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
51000000621 01-7200-01 $150.00
1
Voucher Total $150.00
Cost distribution ledger classification if
claim paid under vehicle highway fund