251505 11/18/15 �,Cqy
' "�� CITY OF CARMEL, INDIANA VENDOR: 361104
® '1 ONE CIVIC SQUARE CYBEX INTERNATIONAL INC CHECK AMOUNT: $**.....147.91
�. _� CARMEL, INDIANA 46032 PO BOX 781401 CHECK NUMBER: 251505
�q„,roN�. PHILADELPHIA PA 19178-1401 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 1053006 147.91 EQUIPMENT REPAIRS & M
EYBETGlobal Headquarters Remit to: p� �+
10 Trotter Drive Cybex International, Inc. �I�CV��`iE
Medway, MA 02053 P.O.Box 781401
Cybex International, Inc. (508)533-4300 Philadelphia, PA 19178-1401 Page 1 of 1
(508)533-5500 fax United States
Sold To. 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: Oct/29/2015
USA Carmel IN 46032 Invoice: 0001053006
USA Customer No: CYB0037634
Payment Terms: Net 30
Bill To: Carmel Clay Parks&Recreation Due Date: Nov/28/2015
Dawn Koepper AMOUNT DUE: 147.91 USD
1411 E. 116th St. Tic 7 TT��,
Carmel IN 46032 RECEIVED
United States
NOV - 2 2015 Shipment Information
Date Shipped: Oct/29/2015
BY: Sales Order No: SVC0727792
Purchase Order No: XX-2923
Pro No: 1 Z5638020157498161
Carrier: United Parcel Service, Inc.
Ship Via: 1 ST 10:30A
Freight Terms: Prepaid
Line Product No. Description Quantity UOM Unit Amt Tax Net Amount
1 BH030207 Pin Weight Selector 6.00 EA 19.43 N 116.58
2 OWTPRTFRT Shipping and Handling Charge 1.00 EA 31.33 N 31.33
Subtotal: 147.91
Subtotal (Sales/Use): 0.00
AMOUNT DUE: 147.91 USD
Thank you. Order entered by Darin Smith
SVC0727792
Dawn at(317)573-4026
dkoepper@carmelclayparks.com
Part number provided by customer
C�4PLEASE 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
10/29/15 1053006 Cybex pins xx2923 $ 147.91
Total $ 147.91
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$
$ 147.91
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or /TIBoard Members
Dept# INVOICE NO CCT# TL AMOUNT
1096-21 1053006 4350000 $ 147.91 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
November 3, 2015
Signature
$ 147.91 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1
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