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248297 08/1 2/1 5 �;/ �• CITY OF CARMEL, INDIANA VENDOR: 361104 },. CHECK AMOUNT: $*******1 18.84* .�; � ., ONE CIVIC SQUARE CYBEX INTERNATIONAL INC s _� CARMEL, INDIANA 46032 PO BOX 781401 CHECK NUMBER: 248297 +M�.,._.� PHILADELPHIA PA 1 91 78-1 401 CHECK DATE: 08/12/15 (TpN Gp' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4350000 1033353 118.84 EQUIPMENT REPAIRS & M —<WEYBET Global Headquarters Remit to: 10 Trotter Drive Cybex International,Inc. INVOICE Medway,MA 02053 P.O.Box 781401 Cybex IntdrnationAl, Inc. (508)533-4300 Philadelphia, PA 19178-1401 Page 1 of 1 (508)533-5500 fax United States Sold Ta Carmel Clay Parks&Recreation Ship Ta Carmel Clay Parks&Recreation 1411 E. 116th St. 1235 Central Park Dr. E. Invoice Information Carmel IN 46032 Monon center Invoice Date: Jul/09/2015 USA Carmel IN 46032 Invoice: 0001033353 USA Customer No: CYB0037634 Payment Terms: Net 30 BIII To: Carmel Clay Parks&Recreation Due Date: Aug/08/2015 Dawn Koe r pper AMOUNT DUE: 118.84 USD 1411 E. 116th St. Carmel IN 46032 JUL 1 3 2015 United States Shipment Information Date Shipped: Jul/09/2015 Sales Order No: SVC0714565 Purchase Order No: _ Pro No: 1Z5638020352051755 Carrier:_- U.sited-P.-arcel_Service,_Inc.- - Ship Via: GROUND Freight Terms: Prepaid Line Product No. Description Quantity UOM Unit Amt Tax Net Amount 1 12050-216 W INPUT ARM 1.00 EA 111.34 N 111.34 2 OWTPRTFRT Shipping and Handling Charge 1.00 EA 7.50 N 7.50 Subtotal: 118.84 Subtotal (Sales/Use): 0.00 AMOUNT DUE: 118.84USD Thank you. Order entered by Darin Smith Black Chrome SN#B03-081205795-0023 Dawn at 3175734026 E4PLEASE NOTE: NEW REMITTANCE ADDRESS CYBEX INTERNATIONAL P.O. Box 781401 PHILADELPHIA, PA19178-1401 Buyer accepts and agrees to prices, specifications, standard terms &conditions of sale, including warranty terms on this document,together with all the attachments hereto 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 781401 Philiadelphia, PA 19178-1401 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 7/9/15 1033353 Cybex input arm xx2400 $ 118.84 Total $ 118.84 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 5-11-10-1.6 120 Clerk-Treasurer Voucher No. Warrant No. 361104 Cybex International, Inc. Allowed 20 P.O. Box 781401 Philiadelphia, PA 19178-1401 In Sum of$ $ 118.84 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO CCT#/TITLI AMOUNT Board Members Dept# 1096-21 1033353 4350000 $ 118.84 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 August 6, 2015 Nmulh�IJ Signature $ 118.84 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund