193672 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: 00353110 Page 1 of 1
0 ONE CIVIC SQUARE BUCKAROO TACK CHECK AMOUNT: $139.99
CARMEL, INDIANA 46032 27498 US 31
ARCADIA IN 46030 CHECK NUMBER: 193672
CHECK DATE: 1/19/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 47396 139.99 MATERIALS SUPPLIES
Buckaroo
BUCKAROO TACK AND WESTERN WEAR
27488 US 31
ARCADIA, IN 46030
317-984-1600
TOLLFREE 866-31DOOT%
11/09/10 Order invoice 0 47396
10:14 um Customer 2579
Sales Person: ANN
Customer:`NA3TENAT[R TREATMENT CITY OF
18729
MISC. MEN'S BOOTS
Reg. 189.98 l 0 159.99 8d. 139.99
Sub-Total: 139.89
Shipping: 0.08
Tax[ O]: EXEMPT*
Total: 139.99
ON RECEIPT On AoCOUot: 138.99
THANK Total Paid: 0.00
YOU! Change: 0.00
HOURS: NON-SAT 10 TO O
CLOSED SUNDAY
RETURN POLICY
*RETURNS AND EXCHANGES NU37 BE
MADE WITHIN 30 DAYS WITH RECEIPT.
*ALL TAGS NUS[ BE ATTACHED.
*ALL ITEMS MUST DE NEW AND NOT
WORN OR WASHED.
*CLEARANCE ITEMS CAN NOT BE RETURNED.
*ALL SADDLES MUST RETURNED IN 3 UAYS
THANK YOU FOR YOUR BUSINESS!
VOUCHER 106862 WARRANT ALLOWED
00353110 IN SUM OF
BUCKAROO
27498 US 31
ARCADIA, IN 46030
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
47396 01- 7200 -01 $139.99
Voucher Total $139.99
Cost distribution ledger classification if
claim paid under vehicle highway f
�b I
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00353110
COWPOKES (FORMERLY BUCKAROO) Purchase Order No.
27498 US 31 Terms
ARCADIA, IN 46030 Due Date 12/29/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/201( 47396 $139.99
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
Date Officer