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258855 05/26/16 CITY OF CARMEL, INDIANA VENDOR: 353696 ® I ONE CIVIC SQUARE POWER SYSTEMS INC CHECK AMOUNT: $*******124.76* r CARMEL, INDIANA 46032 5700 CASEY DRIVE CHECK NUMBER: 258855 KNOXVILLE TN 37909 CHECK DATE: 05/26/16 pro* DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239039 8195281 124.76 GENERAL PROGRAM SUPPL Voucher No. Warrant No. 353696 Power Systems Allowed 20 5700 Casey Drive Knoxville, TN 37909 In Sum of$ $ 124.76 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-21 8195281 4239039 $ 124.76 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 May 19, 2016 Signature $ 124.76 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 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 5/5/16 8195281 Small Fitness Equipment xx3699 $ 124.76 Total $ 124.76 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 20_ Clerk-Treasurer 1 ik2S �Zd- r.,n t * r, rt_ , F,5T&Casey Dr h' `' ' oxville TN C�����i,' 800.321.6975 MAY 0 9 2016 800.298.2057 fax Tax ID: 39-1720480 Fitness@power-systems.com INVOICE Customer: Bill To: Ship To: Carmel Clay Parks And Recreation Carmel Clay Parks And Recreation Accounts Payable 1411 E 116Th St 1411 E 116Th St Carmel IN 46032-7611 Carmel IN 46032-7611 United States - Sold To: - -- - - — Carmel Clay Parks And Recreatio_n- Accounts Payable 1411 E 116Th St Carmel IN 46032-7611 United States Inic��a,eLi'��/5/20�' OR Num Terms: Net 30 Terms Ship Via: FedEx Ground Packing Slip:198924 Order Number: 5178313 Ship Date: 5/5/2016 Line Part Description Quantity Retail Price Your Price Ext Price 1 61706 Deluxe Vinyl Coated Dumbbell 6 Ib. 8 $ 7.95 $ 6.36 $ 50.88 2 61707 Deluxe Vinyl Coated Dumbbell 7 Ib. 8 $ 8.95 $ 7.16 $ 57.28 ;PaymentSchedule '� Sub Total: $ 108.16 Due Date Amount! Misc/Shipping: $ 16.60 1 6/4/2016 124.76'iTax: $ 0.00 Total 124.76, Invoice Total: $ 124.76 Amount Paid;--------$ 0 0,0 Auntimo Due` $ M24*76 Power Systems PS, LLC 5700 Casey Drive Knoxville TN 37909 powersystems.com 9'65'-.799'8223