187299 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00351374 Page 1 of 1
ONE CIVIC SQUARE GODBY HOME FURNISHINGS
a CARMEL, INDIANA 46032 17828 US 31 NORTH CHECK AMOUNT: $1,461.80
WESTFIELD IN 46074
CHECK NUMBER: 187299
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP
102 4463000 12795 1348140 1,461.80 LAZYBOYS
Godb "Quality Furniture, Affordable Prices"
HOME FURNISH NGS CUSTOMER ID I SALES NO. I SALE DATE I PAGE
Family Owned Since 1974 3175712600 1348140 06/26/2010 1
17828 U.S. 31 N.
Westfield, IN 46074 l
317- 896 -3832 J;\ I, I 1 l I J
Customer Copy I IN Vo I C t
SOLD TO: DELIVER TO:
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
317 571 -2631 STATION 43
SLSPRSN DELIVERY PAYMENT TERMS
LLR WESTFIELD TRK ASAP PAID BEFORE DELIVERY
OTY SOLD
STATUS ITEM ID ITEM DESCRIPTION UNIT PRICE EXTENDED PRICE
1 EA LRRO515 LAZBOY 10 -515 C957973 429.95 365.46
RKR RECLINER, NFD 64.49 DISCOUNT
PKG 08800
1 EA LRRO516 LAZBOY 10 -515 C957908 429.95 365.46
RKR RECLINER, NFD 64. DISCOUNT
PKG 08800
1 EA LRR0515 LAZBOY 10 -515 C957973 429.95 365.46
RKR RECLINER, NFD 64.49 DISCOUNT
PKG 08800
1 EA LRR0516 LAZBOY 10 -515 C957908 429.95 365.46
RKR RECLINER, NFD 64.49 DISCOUNT
PKG 08800
SALE REMARKS
CARMEL FIRE DEPT PO NO:12795. THEY
WILL ISSUE CHECK. CUSTOMER TAKING
TODAY.
1,461.84
0.00
0.000 o SALE TOTAL 0.00
No refund or exchanges beyond five (5) days of receipt or delivery of running line merchandise. TAXABLE M ISC. CHARGES 0 00
Special Orders and Lay -a -ways require a 25% non refundable deposit. SALES TAX 1,461 84
Seller is not responsible for damages caused by customer's transportation, assembly, or 0 O 0
maintenance of any type of merchandise. NON -TAX MISC. CHARGES 1,461.84
GRAND TOTAL
Customer signature PAYMENT RECEIVED
BALANCE DUE
VOUCHER NO. WARRANT NO.
ALLOWED 20
Godby Home Furnishings
IN SUM OF
17828 US 31 North
Westfield, IN 46074
$1,461.84
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
12795 1348140 102 630.00 $1,461.84 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
JUL, 2010
.e d
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))
1348140 $1,461.84
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