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251571 11/18/15 CITY OF CARMEL, INDIANA VENDOR: 127250 ® i ONE CIVIC SQUARE H.H. GREGG INC CHECK AMOUNT: $*****3,745.00* ?� CARMEL, INDIANA 46032 4151 E 96TH ST CHECK NUMBER: 251571 INDIANAPOLIS IN 46240 CHECK DATE: 11/18/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4239011 0140-042347 3,745.00 SPECIAL DEPT SUPPLIES hhgregg appliances I electronics I furniture Regular Sale On-Line Original Order:0137-144428 Invoice 0140-042347 Date: 11/13/2015 10:37 4161 E. 96TH ST. Cashier#: P567 INDIANAPOLIS, IN, 46240 (317) 848-1517 1 K74 -Anthony Lovett D S 100808 Purchase Order No: 123456789 e ACCOUNTS PAYABLE i CITY OF CARMEL i CITY OF CARMEL c 1 CIVIC SQUARE P 1 CIVIC SQUARE T CARMEL, IN 46032 r CARMEL, IN 46032 Office: (317) 571-2400 Tax Exempt ID: 0031201550 0 Special Instructions Sls# Qty Model No. Description DelDate: Serial Number Loc Code Tm: is Price Total, **T TAKE ITEMS*** 0001 1 NW PREMIUM SERVICE PLAN DECLINED 11/13/15 0001 T AT 0.00 0.00 0002 1 XBR75X850C LED,SONY,75",UHD 4K,SMART 11/13/15 0001 T AT 3499.99 3499.99 0003 1 OE15OFM XLARGE FULL MOTION,OMNIMOUNT 11/13/15 0001 T AT 199.71 199.71 Was 349.99-Savings of 150.28 0004 1 ARPH12 PLATINUM SERIES HDMI,AR,12FT 1 11/13/15I 10001 ' T I AT 45.30 45.30 Was 89.99-Savings of 44.69 Thank you.Anthony Lovett Subtotal $3,745.00 Accounts Receivable $3,745.00 App 3230 Tax $0.00Invoice Total $3,745.00 Amount Due $3,745.00 Amount Received $3,745.00 Change Due $0.00 C U S T O M E R:: C ORY ` Rev. BS3.94.O.D-4928 The merchandise described above has x0 --216 been inspected and received in good Merchandise Received By Date jditio invoice. X unless otherwise notated on 0140042347 the Merchandise Delivered By Date Returns and exchanges are subject to the Delivery has been completed and no Retain this invoice for future service or returns. Return and Exchange Policy posted at the damage has occured to our personal property. store and available at www.hhgreaa.com. See associate for details. 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/13/15 0140-042347 $3,745.00 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 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 HH Gregg IN SUM OF $ 4161 E. 96th Street Indianapolis, IN 46240 $3,745.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I 0140-042347 I 42-390.111 $3,745.00 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 Friday, o e be 1 1, 2015 r StrcStte 8t,jC o m.r3 iss l o n e r Title Cost distribution ledger classification if claim paid motor vehicle highway fund