304908 11/09/16 Q
CITY OF CARMEL, INDIANA VENDOR: 366176
ONE CIVIC SQUARE BELSON OUTDOORS, INC CHECK AMOUNT: $***•24,677.60'
CARMEL, INDIANA 46032 36810 EAGLE WAY CHECK NUMBER: 304908
CHICAGO IL 60678-1368 CHECK DATE: 11/09/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4463000 145298 24,677.60 FURNITURE & FIXTURES
Voucher No. Warrant No.
Allowed 20
366176 Belson O.utdoors,,Inc.
In Sum of$
$ 24,677.60
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. kCCT#/TITLl AMOUNT Board Members
Dept#
1091 145298 4463000 $ 24,677.60 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 4, 2016
Signature
$ 24,677.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1 -E`iJ EI W ice'
�E
OCT 2 1 2016
Im.voice Date: 10/18/16
® UT ® ®..O'`R S BY: Customer#: CA2208
etson Otdo0rs; LLC
111 N.. R•,�er Road
NorthAur
USA
ora IL 60542;
.,, ;.�
Phone: 630/897-8489
Fax: 630/897-0573
FEINM 39-1720480
Sold To:Carmel Clay Parks& Recreation Ship To: Carmel Clay Parks& Rec
1411 E 116th Street 1195 Central Park Drive West
Carmel, IN 46032 Attn: Dawn
USA Carmel, IN 46032
USA
Ship Date Ship Via F.O.B. Sales Order Date Salesperson Sales Order Number P rchase Order Number Terms
10/18/16 BestwayOrigin 10/03/16 DLTB 145445 40633 Net 10 days
Quantity Item Number Unit of Measure I Discoun o Tax
Order Ship BO Item Description Unit Price 'Extended Price
1 1 0 FREIGHT EA N 2118.60 2118.60
Freight Prepaid
Ship via Best Way per Freight Quote#: Q000104968
Phone Call 24 Hours Prior to Delivery Required!
Point of Contact: Dawn Koepper
Phone Number: 317-573-4026
Liftgate Service Required!
27 27 0 R46-P EA N 712.00 19224.00
Thermoplastic Coated 46"Square Table, Portable
Plastisol I Black Top/Seats
Powder-Coated I Gray Frame
5 5 0 R463-P EA N 667.00 3335.00
Thermoplastic Coated 46" Square Table w/3 Seats, Portable
Plastisol I Black Top/Seats
Powder-Coated I Gray Frame
WaterPark Picnic Tables
40633
GLAccount# 1091000-4463000
WQ185389
Nontaxable 24677.60
Taxable Subtotal 0.00
Tax 0.00
T�otallnuoice 246�7,�7.60
Customer Original Page 1