195515 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 360196 Page 1 of 1
ONE CIVIC SQUARE KIEFER ASSOCIATES
0 CHECK AMOUNT: $19.91
CARMEL, INDIANA 46032 1700 KIEFER DRIVE
ZION IL 60099 CHECK NUMBER: 195515
CHECK DATE: 3/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 CM12704 -16.95 GENERAL PROGRAM SUPPL
1096 4239039 I1695122 36.86 GENERAL PROGRAM SUPPL
Print Date: 01/31/2011 Page: 1 of 1
INVOICE 11695122
Me MOM Address: 1700 KIEFER DR
ZION IL 60099 -5105
United States
Phone: +1- 847 872 -8866
Toll Free Phone: 800 323 -4071
Fax: +1- 847 746 -8888
Email: eSales @kiefer.com
Website: www.kiefer.com
BILL TO: SHIP TO:
Accounts Payable Brooke Tafflinger
Carmel Clay Parks Recreation Carmel Clay Parks Recreation
1411 East 116th Street 1235 Central Park Drive East
(PO# 28059) (PO# 28059)
Carmel IN 46032 Carmel IN 46032
United States United States
INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER CUSTOMER NAME
11695122 01/29/2011 C549779 Accounts Payable
PAYMENT TYPE SHIPMENT TYPE CARRIER BILL TO EMAIL
Payment on Account C. USPS FedEx
ORDER NUMBER ORDER DATE SHIPMENT NUMBER SHIPMENT DATE
0169491 01/26/2011 S241741 01/28/2011
CUSTOMER PO SHIP TO EMAIL TRACKING NUMBER
28059 364670240001454
S.No. Item Number Item Name Promo. Quantity Price Extended Price
Code
1 650619.13Iue KIEFER AQUA -CELL 0111 1.00 27.95 27.95
ANKLE CUFF
PAIR KIEFER
AQUA -CELL ANKLE
CUFF PAIR.Blue
Total Item Price 27.95
Shipping 8.91
Total Discount 0.00
Total Shipping and Handling Charges 8.91
Total Non Freight Surcharge 0.00
Sales Tax (0.00% on $27.95 included.) 0.00
Grand Total 36.86
03/02/2011 10:17 8477468888 KIEFER SPORTS GROUP PAGE 04/06
Page 1 of 1
Company Logo
KWer
Adolph Kiefer Aasoclalos Print 0.ito� 03!0212011
Company Addmw 1700 KIEFERDR Pe 1 of T
ZION IL 6o09g•aio;
United States
Company Phone, 1.847$72•altag Credit Memo
Toll Froa Phone: 600.3231071
Company Pox: r1-847.746 -8888
Company Email! eSalealDkieFtr.com
Comaaty Weballe: Ww .xiefer,com
HILL TO: SHIP TO:
Accounts payable Brooke Tafflinger
0411 East 176th Street 1235 Central Park Drlva East
Carm el l IN (PCff 28059)
Carmel 4 46032 Carmel IN 46032
United Sis�S United S1010S
Credit Memo Number. Credit Memo Date! Customer Number: E -Mail:
CM 12704 0112712011 0649779
In.olce Number. Refund Reference: Currency: St
11689736 US Dollar Cosod
S.No, Product Number Product Name Quantity Not Price Adjustment Restocking Extendod
Per Unit Amount Fop Price
Kf EFER
1 $11400.10 WRISTIANKLE 1 $16.95 $0.00 $16.95
WE IGHT5,10
Credit Memo subotal $16.
Total Restocking Fee $0,00
All Price Quoted In U5 Dollar
Shipping 4,063
Sales Tsx 0,00% on 10,95 0,00
Adjustment Reason RMA Amount
Shipping S-4.08
Grand T 0 10 1 S 16.9$
Purchase
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Line Descr ,:2X81 ICY
Purchaser Date_
Approval Date
javaseript: parer. t. objDoCUmentPreview.DooumentHTML 03/02/2011
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.
360196 Adolph Kiefer Associates Terms
1700 Kiefer Dr
Zion, IL 60099 -5105
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1129111 11695122 Swim supplies 28059 36.86
1127111 CM12704 Credit for return 28059 (16.95)
Total 19.91
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
Voucher No. Warrant No.
360196 Adolph Kiefer Associates Allowed 20
1700 Kiefer Dr
Zion, IL 60099 -5105
In Sum of$
19.91
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. 4,CCT WTITLE AMOUNT Board Members
Dept
1096 -70 11695122 4239039 36.86 1 hereby certify that the attached invoice(s), or
1096 -70 CM12704 4239039 (16.95) 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
10 -Mar 2011
Signature
19.91 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund