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184900 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 353696 Page 1 of 1 ONE CIVIC SQUARE POWER SYSTEMS INC CARMEL, INDIANA 46032 PO BOX 51030 CHECK AMOUNT: $213.46 KNOXVILLE TN 37950 -1030 o CHECK NUMBER: 184900 CHECK DATE: 4127/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239099 1025536 213.46 OTHER MISCELLANOUS P.,0.,gox51030 37950 INVO ICE ®i POW 1 800 3 121 -69 1- 800- 21 -6975 1025536 (865) 769 -8223 3/30/2010 l E 5 (865) 769 -8211 FAX 1 of 1 www.00wer-systems.com Email to fitness @power- systems.com Bill To: CARMEL, CITY OF Ship To: RECEIVING ACCOUNTS PAYABLE CITY OF CARMEL 1 CIVIC SQ MONON CENTERILINDSEY WILLARD CARMEL, IN 46032 -2584 1235 CENTRAL PARK DR E USA PO 23339 CARMEL, IN 46032 -4421 USA e. o a 432743 amm 3/30/2010 Net 30 Days 4/29/2010 23339 2526593 o s M x 1 90805 Deluxe Club Mat 72" L x 24" W x 2" thick Jet BI 3 3 0 EA 69.95 209.85 o �t� i}�nugs E u .r�anc APR 10l 0 P.O. off F G.L.! Bud 23� Purohaw D Approv Date $209.85 $21.00 $24.61 $0.00 $0.00 $213.46 COMMENTS r_w_invprint_ A 1.5% Finance Charge or a $5.00 minimum charge will be applied to all balances over 30 days. 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 P.O. Box 51030 Knoxville, TN 37950 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3/30110 1025536 Fitness equipment 23339 213.46 Total 213.46 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- 14 -1.6 20_ Clerk- Treasurer Voucher No. Warrant No. 353696 Power Systems Allowed 20 P.O. Box 51030 Knoxville, TN 37950 In Sum of 2.13.46 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1096 -21 1025536 4239099 213.46 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 22 -Apr 2010 Signature 213.46 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund