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186209 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 026625 Page 1 of 1 ONE CIVIC SQUARE BOB BLOCK FITNESS EQUIP io CARMEL, INDIANA 46032 8128 CASTLEWAY COURT WEST CHECK AMOUNT: $4,100.00 INDIANAPOLIS IN 46250 CHECK NUMBER: 186209 CHECK DATE: 6/9/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467099 12790 0022281 4,100.00 d ff"A E 71C INVOICE C INVOICE NUMBER Q0222$ 10 Eq INVOICE DATE 05/28/20 5128 Costlewav Court West SALES PERSON TIM RAGAN Indianapolis, IN 46250 CUSTOMER NUMBER 01 (317) 845 -7700 Fax: (317) 845 -7704 ivivw, bobblockf lness. cony SOLD TO: CARMEL FIRE DEPARTMENT SHIP TO: CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 540 W 136TH STREET CARMEL, IN 46032 CARMEL, IN 46032 CONEIRM TQ_ David Mead _571 -2625 P.O. NUMBER PAID BY: CHECK# REFERENCE TER 12790 DUE ON RECE ITEM DL'SCRIPTION ORDERED SHIPPED B/O UNIT PRICE TO "I'AL TRCS500T2W CS500 TREADMILL 2 WINDOW I 1 0 4,100.00 4,100.00 DISPLAY WARRANTY: 5 YEARS PART I YEAR LABOR SERIAL 4: 10- TCS500105D SERIAL 9: 10- 300403E INSTALLED BY: BEN JOSHUA THANK YOU FOR THE OPPORTUNITY TO BE OFSERVICE Net invoice: 4.100.00 Freight: 0.00 Sales Tax: 0.00 4,100.00 Less Deposit: 0.00 4,100.00 VOUCHER NO. WARRANT NO. ALLOWED 20 Bob Block Fitness IN SUM OF 8128 Castleway Court West Indianapolis, IN 46250 $4,100.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# /Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 12790 0022281 102- 670.99 $4,100.00 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 IN 2010 Fire Chief Title Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 0022281 $4,100.00 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