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187000 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1 ONE CIVIC SQUARE RED WING SHOE STORES INC CARMEL, INDIANA 46032 6653 E 82ND ST CHECK AMOUNT: $494.97 INDPLS IN 46250 CHECK NUMBER: 187000 CHECK DATE: 6/23/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4356003 3198 494.97 SAFETY ACCESSORIES Original Invoice BILL TO REMIT TO ATTN: BONNIE CALLAHAN Red Wing Shoe Store CAR:MEL CrlY STREET DEPT Castleton Village 3400 W 131ST ST 6653 East 82nd St. WESTI IELD, IN 46074 Indianapolis, IN 4625011577 (31.7)577 -0760 Invoice Number Invoice Date Terms Description 5100000031.98 06/15/2010 Net 30 Ticket Date Purchased By Other Information Item Amount 00051028734 06109/2010 TOWNSEND, SCOTT 02414D 120 251.99 Total $251.99 Net Total $251.99 00051028736 06/09/2010 STEWART, JEFF 06670D t 10 121.49 Total $121.49 Net Total $121.49 00051028739 06/09/2010 PRIVETT, SHAUN 06670D 105 121.49 Total $121A9 Net Total $121.49 Total Merch $494.97 Customer Tax $0.00 Maj_ Acct_ Tax $0.00 Message: Total Charges $494.97 Customer Payment $0.00 Maj. Acct. Payment $0.00 Total Due $494.97 Date Due 07/15/2010 A. VOUCHER NO. WARRANT NO. ALLOWED 20 Red Wing Shoe Store IN SUM OF 6653 E. 82nd Street Indianapolis, IN 46250 -4577 $494.97 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Member: 2201 5100000003198 43- 560.03 $494.97 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 Thursday r(IfA 17 Street;Commi sbnr 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)) 06/15/10 5100000003198 $494.97 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