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191126 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 026625 Page 1 of 1 ONE CIVIC SQUARE BOB BLOCK FITNESS EQUIP CHECK AMOUNT: $105.00 y ro CARMEL. INDIANA 46032 8128 A T INDIANAPOL A CSO C O UR T WEST CHECK NUMBER: 191126 CHECK DATE: 10/27/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4350900 0076844 105.00 OTHER CON'T' SERVICES ffgp E qu i PMP [7 INVOICE NUMBER 00768 L INVOICE DATE o9/29/z olo 8128Cas•ihnvm)Crnrl Gres! SALES P]>RSON MIKE PINE Indianapolis, 11,'46250 CUS"I 01 CAROL (317) 845 7700 Fax: (317) 84 -7704 irri i; bobbl ock f irness. c•onz SOLD "TO: CARMEL FIRE DEPARTMENT SI -111 TO: CARMEL FIRE DEPARTMENT 10701 N College Ave 10701 N College Ave INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280 CONFIRM TO: Douglas Callahan P.O. NUMBER PAID BY: CHF1 CK# REI'ERI NCE TERMS DUE ON RECEIPT DESCRIPTION ORDERI ?:D SHIPPED 13/0 UNTIT PRICF "TOTAL SERVICE CALL ON 9/28/10 BY MIKE PINE TRUE 725 TREADMILL PULLEY BROKE LOOSE FROM MOTOR. R WAS RUBBING ON THE FRAME MOVED PULLEY [SACK OVER R RE-TIGHTENED SET SCREWS iLABOR SERVICE LABOR 80.00 ITR1P SERVICE TRIP CHARGE 25.00 T11AAW YOU FOR 7HL OPPOR7UN17'Y 7013E OF SER I/ICL Net Invoice: 105.00 F reight: 0.00 sales 7 "ax: 0.00 10 5.00 Less Deposit: 0.00 105.00 VOUCHER NO. WARRANT NO, ALLOWED 20 Bob B_ lock Fitness IN SUM OF$ 8128 Castleway Court West Indianapolis, IN 46250 $105.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #ITITLE AMOUNT Board Members 1120 0076844 43- 509.00 $105.00 I 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 OCT 2 X898 f ,rl c p r 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)) 0076844 Sta, 45 Treadmill $105.00 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