190452 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364134 Page 1 of 1
ONE CIVIC SQUARE ROCKY MOUNTAIN SUNSCREEN CHECK AMOUNT: $222.77
CARMEL, INDIANA 46032 14700 W 66TH PLACE, SUITE 2
ARVADACO 80004 CHECK NUMBER: 190452
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239012 22560 222.77 SAFETY SUPPLIES
Rocky mountain sunscreen Invoice
14700 W. 66th Place, Suite #2 DATE NUMBER
Arvada, CO 80004 ROCHY
888.356.8899; 303.940.9809 Fax AdAmounTAin 7/19!2010 22s6o
www.rmsunscreen.com sunscreen
BILL TO SHIP TO
Carmel Clay Park Rec Carmel Clay Pork Rec
Ferro Gerske Carrie Keaveney
1411 E. 1 16th St, 1235 Central Park Dr. East
Carmel, IN 46032 Carmel, IN 46032
P.O. Number. TERMS DUE DATE REP SHIP F.O.B. ORDER DATE
23780 Net 30 8/18/2010 HOU 7/19/2010 Arvada 07 /19!10
ITEM CODE DESCRIPTION QUANTITY PRICE EA. AMOUNT
10104 Gallon Pump SPF -30 Sunscreen 2 103.50 207.00
Subtotal 207.00
Shipping Shipping Handling 1 15.77 15.77
JAR V
Sty 0 2010
BY:
SEP 2 0 2010
BY:.........
Thank you for your business.
TOTAL $222.77
Title to above merchandise delivered is retained by the seller until paid in full,
including freight- All invoices not paid in full within above terms are subject to n
maximum allowable service charges retroactive to the shipping date. Bolanee Due $222.77
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.
364134 Rocky Mountain Sunscreen Terms
14700 W 66th Place, Suite 2
Arvada, CO 80004
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/19/10 22560 Sunscreen 23780 222.77
Total 222.77
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
Voucher No. Warrant No.
364134 Rocky Mountain Sunscreen Allowed 20
14700 W 66th Place, Suite 2
Arvada, CO 80004
In Sum of
222.77
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1094 22560 4239012 222.77 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
23 -Sep 2010
Signature
222.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund