251044 11/04/15 a°,.C4Ab
CITY OF CARMEL, INDIANA VENDOR: 361104
® ONE CIVIC SQUARE CYBEX INTERNATIONAL INC CHECK AMOUNT: $**......19.26*
�. ? CARMEL, INDIANA 46032 PO BOX 761401 CHECK NUMBER: 251044
��''<ron�O' PHILADELPHIA PA 19178-1401 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 1051054 19.26 EQUIPMENT REPAIRS & M
Global Headquarters Remit to:
10 Trotter Drive Cybex International, Inc. INVOICE
Medway, MA 02053 P.O. Box 781401
Cybex International, Inc. (508)533-4300 Philadelphia, PA 19178-1401
(508)533-5500 fax United States Page 1 of 1
Sold To: Carmel Clay Parks&Recreation Ship To: Carmel Clay Parks&Recreation
1411 E. 116th St. 1235 Central Park Dr. E. Invoice Information
Carmel IN 46032 Monon center Invoice Date: Oct/19/2015
USA Carmel IN 46032 Invoice: 0001051054
USA Customer No: CYB0037634
Payment Terms: Net 30
Bill To: Carmel Clay Parks&Recreation Due Date: Nov/18/2015
Dawn Koepper AMOUNT DUE: 19.26 USD
1411 E. 116th St. RECEIVED
IVSD
Carmel IN 46032
United States OCT 2 8 2015
Shipment Information
I-3Y: Date Shipped: Oct/19/2015
Sales Order No: WEB5040204
Purchase Order No: 39105
Pro No: 1Z5638020356773405
Carrier: - ----United-Parcel-Se.Jice,i c.-- -
Ship Via: GROUND
Freight Terms: Pre aid
Line Product No. Description Quantity UOM Unit Amt Tax Net Amount
1 11180-305 P Spacer 2.00 EA 9.63 N 19.26
Subtotal: 19.26
Subtotal (Sales/Use): 0.00
AMOUNT DUE: 19.26 USD
Order entered by Maria Vine. Thank you for your order.
PLEASE 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
10/19/15 1051054 Repair parts for Fitness Equipment 39105 $ 19.26
Total $ 19.26
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
120
Clerk-Treasurer
Voucher No. Warrant No.
361104 Cybex International, Inc. Allowed 20
P.O. Box 781401
Philiadelphia, PA 19178-1401
In Sum of$
$ 19.26
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
------------------
PO#or Board Members
Dept# INVOICE NO CCT#/TITL AMOUNT
1096-21 1051054 4350000 $ 19.26 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
October 26, 2015
Signature
$ 19.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund