160300 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 355637 Page 1 of 1
s• 0 ONE CIVIC SQUARE CITY COMFORTS, INC CHECK AMOUNT: $124.75
CARMEL, INDIANA 46032 816 NE 91ST ST
SEATTLE WA 98115 CHECK NUMBER: 160300
y^ CHECK DATE: 6/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4239002 17824 124.75 BOOKS
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5/27/
5 O8
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1 6tyComforts Inc.r
816 NE 91st Street_
S eattl e WA 98_115 City of Carmel
david cit comforts com
`206 355 4442 Dept 6f Community S�rvjces
L206 202 3212 fax
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a
iSold/Shipped to A Sue Coy, Office Manager
Department of C€ mm€ ni y Services
y of Carmel
'Ors ,ivio Square
Carmel, RA 46032
X3..17) 571-2418
Your PO 17824
;fo
City
y Comforts, Revised ISBN 0- 9642680 -1 -9 I
t 3
lNumber books ordered._...__
Retail price per book $23 95� _.m... m�.m
Number books shipped: 5
t
#books rice
p per book i
3
$23.95 $119.751
Shipping by USPS I!�dia'Mail $5-W
'Handling $0.00
x 1 E
Total
No Returns
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Thank you!
0 df INDIANA RETAIL TAX EXEMPT PACE
k .1 4t y- Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
II FEDERAL EXCISE TAX EXEMPT -7 ,c V
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR f J r f"
SHIP TO
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Lyoo
on
Ole
4p f' V i
1 F
Send Invoice To: I�
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENTTO PAY FOR THE ABOVE ORDER.
i"
C.O.D. SHIPMENTS CANNOT BE ACCEPTED, ORDERED BYC
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. la
1 8g ,4 CLERK- TREASURER
DOCUMENT CONTROL NO. V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO..
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #1TITLE AMOUNT
DEPT. 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescrib.�i by,5tate 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 j�
�a LC Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
sh? TO I q, 75
Total /a '1, 75
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.
i
ALLOWED 20
IN SUM OF
ty /(o IV E
�a q. 15
ON ACCOUNT OF APPROPRIATION FOR
�Wcs
RO 7;� 78a Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
/78 3g 0.oa iaU 75 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
4 0 08
J� bi n u ,�)Ocs
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund