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