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303211 09/22/16
r CAq CITY OF CARMEL, INDIANA VENDOR: 357203 ONE CIVIC SQUARE JEFFREY EADS CHECK AMOUNT: $*««««««*53.94* CARMEL, INDIANA 46032 5671 HARE DRIVE CHECK NUMBER: 303211 'M,iTON�o NOBLESVILLE IN 46062 CHECK DATE: 09/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 09041602 26.97 OTHER EXPENSES 651 5023990 09041602 26.97 OTHER EXPENSES VOUCHER # 166209 WARRANT # ALLOWED 357203 IN SUM OF $ EADS, JEFF utilities Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 09041602 01-7200-07 26.97 `ll Voucher Total 26.97 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 357203 EADS, JEFF Purchase Order No. utilities Terms Due Date 9/20/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/20/2016 09041602 26.97 hereby certify that the attached invoice(s), or bill(s) is (are)true and ;orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer VOUCHER # 162773 WARRANT # ALLOWED 357203 IN SUM OF $ EADS, JEFF Utilities Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 09041602 01-6200-07 26.97 Voucher Total 26.97 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 357203 EADS, JEFF Purchase Order No. Utilities Terms Due Date 9/20/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/20/2016 09041602 26.97 hereby certify that the attached invoice(s), or bill(s) is (are)true and -orrect and I have audited same in accordance with IC 5-11-10-1.6 Date Officer � �EST.1920 �J J Edinburgh Premium Outlets 00414 D FINBURGH PREMIUM OUTLETS 3000 Outlet Drive, Space F120 3005 Outlet Drive Edinburgh ,IN 46124 Suite E090 812-526-9006 Edinburgh,IN 46124 (812)526-2134 - 3:28 PM 9/4/167� 3:15 PM 09/0Store: 02271 4/2016 Trans . 4167 skor& Store: 00414 Trans. : 7744 Reg. : 002 Till: 002 Reg. . 004 Cashier: Debra Sales: 999999 Cashier: VS0982 Sales: US0982 Member ID: 70100358538871 SAL[ Sale i �Ill�lllilllll�lill�llllllll�illllllllillllllllllllll�l�IIIII�I�I III 11I IIII I 111 00414002416720160904 02271004774420160904 MR TIMBERLINE RIPSTOP CAR 29.99 T REO RCTIUE FLEX SLIM FLA 26.97 T 400009657302 1 @ 29.994/23 Outlet US 0023849870 1 @ 44.95 Deal Discount Amt. (17.98) MR M WILDRIVER CARGO SHOR 14.99 T 40% OFF SLCT AE MERCH 400009672718 1 L 14.99 AEO ACTIVE FLEX SLIM FLA 26.97 T Subtotal 44.98 00237347.05 1 @ 44.95 Total Sales Tax 3.15 Deal Discount Amt. (17.98) 40% OFF SLCT RE MERCH Total 48.13 Cash 60.00 Subtotal 89.90 Total Tender 60.00 Total Discount (35.96) Total Sales Tax 3.78 Charge Due (11 .87) Total 57.72 Loyalty #. 920745940 Credit 57.72 Card: MasterCard r�(� i' �� Customer Copy Account: 6838 qty. l / -------------------------------------------- Ruth: 288287 (A) Application ID: Debit MasterCard Thank you for shopping at Eddie Bauer! Application Name: Debit MasterCard --------------------------------------------- PAN ----------------- -_________------_-__PAN Seg Num. : 01 Verification: Signature FINEST QURLITY Capture Method: ICC 100% GUARANTEED Total Tender $ 57.72 PLEASE RETAIN ORIGINAL RECEIPT FOR RETURN OR EXCHANGE Change Due 0.00 SHOP ONLINE 24 HOURS A DAY AT WWW.EDDIEBAUER.COM 9/8/2016 Transaction Details Transaction Details FORUM" C R E D I T U N 1 0 N 9/5/2016 Eff. 9/4/2016 WITHDRAWAL @ 5691_A EAGLE OUTFTR00022715 A E AGILE OUTFTR0002 EDINBURGH INUS Trace#96332 96 -$57.72 Hide Merno!Categorizations MEMO (No memo text) CATEGORIES Clothing $57.72 Generated on 9/8/2016 9:05:25 AM ©2016 FORUM Credit Union.All rights reserved. https://www.forumcuonline.com/History/Pri ntTransaction 1/1