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198636 06/22/2011 CITY OF CARMEL, INDIANA VENDOR. 365421 Page 1 of 1 ONE CIVIC SQUARE MAC DESIGNS INC CARMEL, INDIANA 46032 10093RD AVE SW CHECK AMOUNT: $2,825.00 CARMEL IN 46032 CHECK NUMBER: 198636 CHECK DATE: 612 212 011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4356001 10217 2,825.00 UNIFORMS F a V.. 1009 13171580 9390 Invoice E10 N 3rd Ave SW Date Invoice NNN! /NNN J9$f /NN NN A., Carmel, IN 46032 6/16/2011 10217 Bill To Ship To CARMEL STREET DEPARTMENT BONNIE CALLAHAN 3400 N 131ST ST CARMEL. IN 46074 P.O. Number Terms Rep Ship Via Net 30 MARTY 6/16/2011 UPS Quantity Item Code Description Price Each Amount 100 S/S SHIRT SHORT SLEEVE SHIRT ASH 5 50 55000 35 S/S SHIRT SHORT SLEEVE SHIRT' ASH XXL 7 50 26250 30 S/S SHIRT SHORT SLEEVE SHIRT ASH XXXL 8.50 255.00 45 S/S SHIRT SHORT SLEEVE SHIRT ASH 7.50 337.50 30 S/S SHIRT SHORT SLEEVE SHIRT ASH XXL 7.50 225 00 50 POLO POLO ASH 18 00 900.00 10 POLO POLO ASH XXL 19.00 190.00 5 POLO POLO ASH XXXL 21 00 10500 Total $2.825 00 If you have a question or dispute regarding an invoice please call us at 317580 -9390 or 800 -953 -9939. Accounts past due will be charged 1.5% tnterst I M" annual rate Balance Due $2,825.00 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)) 06/16111 10217 $2,825.00 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Mac Designs, Inc. IN SUM OF 1009 3rd Ave. S. W. Carmel, IN 46032 $2,825.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 2201 10217 43- 560.01 $2,825.00 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 Fri June 17, 2011 x-44 Street Commisspner ssioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund