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185702 05/26/2010 „w CITY OF CARMEL, INDIANA VENDOR: 361104 Page 1 of 1 4, ONE CIVIC SQUARE CYBEX INTERNATIONAL INC CARMEL, INDIANA 46032 PO BOX 8500-1401 CHECK AMOUNT: $133.50 PHILADELPHIA PA 19178 -1401 CHECK NUMBER: 185702 CHECK DATE: 5126/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4238000 700809 133.50 SMALL TOOLS MINOR E Global Headquarters Remit to: INVOICE 10 Trotter Drive Cybex International, Inc. Medway, MA 02053 P.O. Box 8500 -1401 (508) 533 -4300 Philadelphia, PA 19170 -1401 Page: 1 Cybex International, Inc. (508) 533 -5500 fax United States Sold To: Carmel Clay Parks Recreation Ship To: Carmel Clay Parks Recreation Invoice Information 1411 E. 116th St. The Morton Center Invoice Date: 03/10/10 Carmel, IN 46032 Carmel, IN 46032 Invoice: 0000700809 USA USA Customer No: CYB0037634 Payment Terms: NET30 Due Date: 04 -09 -10 AMOUNT DUE: 133.50 Bill To: Carmel Clay Parks Recreation Shipment Information 1411 E. 116th St. Date Shipped: 03 -09 -10 Carmel, IN 46032 Sales Order No: SVC0490722 USA Purchase Oder No: MB000808 Pro No: lZ5638020354296701 Carrier: United Parcel Service, Inc. Ship Via: GROUND Freight Terms: Prepaid Product No. Description Serial No. Quantity UOM Unit Amt Tax Net Amount 531OPO44 Wt Selector Pin F /Cc 10.0 EA 12.6 N 126.00 OWTPRTFRT Shipping and Handling Charge 1.0 EA 7.5 N 7.50 Purchase Description P.O.# LLC) "0`LL PorF G.tr i tic z� zLsi coo Bud "'t Una Da�or Sm -'7 r� 1� 1 Yl the t�L Ul p Purchaser l (rl �t' Date j L O APPMV t Da*-- Subtotal: 133.50 Subtotal (Sales /Use) 0.00 AMOUNT DUE: 133.50 USD 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. 361104 Cybex International, Inc. Terms P.O. Sox 8500 -1401 Philiadelphia, PA 19178 -1401 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3110/10 700809 Fitness equipment parts 133.50 T ©tal 133.50 I 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 Voucher No. Warrant No. 361104 Cybex International, Inc. Allowed 20 P.O. Box 8500 -1401 Philiadelphia, PA 19178 -1401 In Sum of 133.50 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO =T #rrITL1 AMOUNT Board Members Dept 1096 -21 700809 4238000 133.50 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 20 -May 2010 Signature 133.50 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund