248491 08/12/15 Ji�'Cly*`
CITY OF CARMEL, INDIANA VENDOR: 353696
® it ONE CIVIC SQUARE POWER SYSTEMS INC CHECK AMOUNT: S'"""'"68.29'
CARMEL, INDIANA 46032 5700 CASEY DRIVE CHECK NUMBER: 248491
y,�_oH,.�` KNOXVILLE TN 37909 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4238000 8122826 68.29 SMALL TOOLS & MINOR E
5700 Casey Dr.
1:)OWER Knoxville, TN 37909
bA%w4`ySTEMS,,, 800.321.6975
fitness@power-systems.com 865.769.8223
800.298.2057 fax
Tax ID: 47-2613595
ME •
o E_ M�
Bill To: Ship To:
Carmel Clay Parks And Recreation Monon Community Center
Accounts Payable 1235 Central Park Dr E
1411 E 116Th St Carmel IN 46032-4421
Carmel IN 46032-7611 � rUnited States
JUL 1 7 2015
Sold To:
Carmel Clay Parks And Recreation
_ --- Accounts Payable
1411 E 116Th St
Carmel IN 46032-7611
United States
Invoice Date: 7/10/2015
PO Number:XX-2448 Terms: Net 30 Terms Ship Via: FedEx Ground
Packing Slip:124667 Order Number: 5109383 Ship Date: 7/10/2015
Line Part Description Quantity Retail Price Your Price Ext Price
1 50475 Lock-Jaw Barbell Collar- Olympic 1 $ 39.95 $ 33.96 $ 33.96
2 67085 Bar Wrap Pad 2 $ 14.95 $ 12.71 $ 25.42
Pavr»entSdhedule; ` ' Sub Total: $ 59.38
wap' Due Date ;r Amount;
1 8/9/2015 6.-.----. .. Misc/Shipping: $ 8.91
8.292.--
Tax: $ 0.00
Total 68.29 Invoice Total: $ 68.29
_- _ - -- Amount Paid: $ 0.00
Amount Due: $ 68.29
Power Systems PS, LLC 5700 Casey Drive Knoxville TN 37909 powersystems.com 865.769.8223
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.
353696 Power Systems Terms
5700 Casey Drive
Knoxville, TN 37909
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/10/15 8122826 Small part replacements for Fitness Center xx2448 $ 68.29
Total $ 68.29
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.
353696 Power Systems Allowed 20
5700 Casey Drive
Knoxville, TN 37909
In Sum of$
$ 68.29
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1096-21 8122826 4238000 $ 68.29 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
IpAdLL��
Signature
$ 68.29 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund