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312819 06/16/17 CITY OF CARMEL, INDIANA VENDOR: 353696 ONE CIVIC SQUARE POWER SYSTEMS INC CHECK AMOUNT: $"''"*213.49' CARMEL, INDIANA 46032 5700 CASEY DRIVE CHECK NUMBER: 312819. KNOXVILLE TN 37909 CHECK DATE: 06/16/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4238000 8284032 213.49 SMALL TOOLS & MINOR E 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 6/2/17 8284032 Fitness Small Equipment Replacement xx5393 $ 213.49 Total $ 213.49 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 � Knox OWE S STEMS Casey Dr. Knoxville,TN 37909 800.321.6975 800.298.2057 fax Tax ID: 39-1720480 Fitness@power-systems.com • - • Bill To: Ship To: Carmel Clay Parks And Recreation Matt Whirley Accounts Payable Monon Community Center 1411 E 116Th St 1235 Central Park Dr E Carmel IN 46032-7611 Carmel IN 46032-4421 United States Sold To: Carmel Clay Parks And Recreation Accounts Payable 1411 E 116Th St Carmel IN 46032-7611 United States Invoice Date:6/2/2017 PO Number:XX-5393 Terms: Net 30 Terms Ship Via: FedEx Ground Packing Slip:289771 Order Number: 5259800 Ship Date: 6/2/2017 Line Part Description Quantity Retail Price Your Price Ext Price 1 61815 Pro Power Bar -700 Ib. Capacity - Nickel 1 $ 226.39 $ 185.64 $ 185.64 "R P FBY JUN 0 8 1017 :.. Sub Total: $ 185.64 -- "UTF6 Misc/Shipping: $ 27.85 1 7/2/2017 213.49 i Tax: $ 0.00 Total 213.49; Invoice Total: $ 213.49 Amount Paid: $ 0.00 Amount Due: $ 213.49 Power Systems PS, LLC 5700 Casey Drive Knoxville TN 37909 powersystems.com 865.769.8223