192449 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00351374 Page 1 of 1
ONE CIVIC SQUARE GODBY HOME FURNISHINGS CHECK AMOUNT: $730.92
CARMEL, INDIANA 46032 17828 US 31 NORTH
WESTFIELD IN 46074 CHECK NUMBER: 192449
CHECK DATE: 12/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4463000 1370930 730.92 FURNITURE FIXTURES
F "Quality Furniture, Affordable Prices"
by
�IE,',URNIS�'l1IGS ER ID
SALES NC}.
I CUSTflM SALE DATE PAGE
3175712600: 1 1,
Family Owned Since 1974
17828 U.S. 31 N.
Westfield, IN 46074 r°
317 896 3832 a!iz\ I �c� J ��JI J r11
Customer Copy �'���`�r��`��K!
SOLDTgARMEL FIRE DEPARTMENT DELIV� FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
317 -571 -2631 STATION 43
_e—
SLSPRSI` i C}EI IVERY PAYM1AENT TERMS
SLR JS CUST PICK UP 11/23/20101 PAID BEFORE ^DEL IVERY
OTYSO
ITEM
2._.__� EA LRR5183 LAZBOY 10
515. M D865183
STATUSD E� ID- DESCRIPTI UNIT PRICE EXTENDED PRICE
ICE
365:46:; 730.92
RKR RECLINER, BLUE
PKG 08800.:.
SALE REMARKS
E
FOR STATION 43, WILL BE BILLING-- j
THIS
A,
0
z
0 .w
x
A
t
by 7 9.2
1
.SALE TOTAL 3
0
No refund or ezchanges,beyond five (5) days of receipt or delivery wa s of running line merchandise. 0 A4I3LE MISC. CF IAR�aI =S a 9 t 0
Special Orders and La a re uire a 25'6 on refundable de osd
P n e 0 SALES TAX.
P y' Y 9,. er ..b^
xl
'Seller is not responsible for, damages caused by customs transportation; assembly or Q 0 0
ma of any rypeofin erchand lse. 'NON TAX"MISC. CHARGES,,.
7 3 0 9'2
GRAND TOTAL 0 0 .4 r#
�TAYMENT RECEIVED
l Customer Signature
2
I 4 r BALANCE DUE
VOUCHER NO. WARRANT NO.
ALLOWED 20
Godby Home Furnishings
IN SUM OF
17828 US 31 North
Westfield, IN 46074
$730.92
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 1370930 102- 630.00 $730.92 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
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))
1370930 Sta. 43 $730.92
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