HomeMy WebLinkAbout200501 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 364209 Page 1 of 1
ONE CIVIC SQUARE JOHNSON HEALTH TECH NA INC
CHECK AMOUNT: $1,083.44
CARMEL INDIANA 46032
d,,�`•r' 1600 LANDMARK DRIVE
COTTAGE GROVE WI 53527 CHECK NUMBER: 200501
CHECK DATE: 8117/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4237000 9000799802 1,083.44 REPAIR PARTS
Johnson Health Tech NA Inc. INVOICE
1600 Landmark Drive Document 9000799802
Cottage Grove, WI 53527
S 0 9Y Phone: 608 839 -1240 Date 07/13/2011
Fax: 608 839 -1260 Page 1 of 1
Bill -To: 33001910 Ship -To: 33001910
CARMEL CLAY PARKS AND REC CARMEL CLAY PARKS AND REC
1411 E 116th St 1411 E 116th St
Carmel, IN 46032 Carmel, IN 46032
Comment:
Shipping Comment:
Purchase Order No. Sales Order No. Sales Person ID Shipping Method Terms Due Date
28753 DHJVQ1300 100423998 GLTM (Greattakes -TM) UPS GROUND 100% PTS 07/13/2011
LN# Qty. Model Number Item Number Description List Price Net Unit Price Ext. Price
0010 1 MX15 -DTV ZMD3002555 TV -15" Matrix Mye 1,495.00- 884.44 884.44'
Serial Number(s): MX15DTV11053518
0020 1 0000093108 Control Box;TV07 83.25 85.00 85.00
0030 1 0000093285 Digital Dispatch Roll 14.98 15.00 15.00
WIre;800L,RJ45;TV0
Q 2 ON F! 7
J U L 1 G 2011
]BY:
P irchase
D criptiw
P(7.# P
GL.# ']d OD
Bud get esc 1
Lie r
P rchaser Date
proval Date
Remit To: Discounts 0.00 Freight 99.00
Johnson Health Tech NA Inc. Misc./Duty 0.00 freight Disc. 0.00
1600 Landmark Drive Other Fees 0.00 Tax 0.00
Cottage Grove, WI 53527
Subtotal 984.44 Totah USD ''..1 083.44
A Service Charge of 1.5% Per Month
Will Apply To All Delinquent Balances
0 I5r ®/a�Zo vrsfoN FrrNess. r. 1 X
F I T N E S S
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.
364209 Johnson Health Tech NA, Inc. Terms
1600 Landmark Drive
Cottage Grove, WI 53527
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/13/11 9000799802 TV repair parts 28753 1,083.44
Total 1,083.44
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.
364209 Johnson Health Tech NA, Inc. Allowed 20
1600 Landmark Drive
Cottage Grove, WI 53527
In Sum of
1,083.44
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1096 -21 9000799802 4237000 1,083.44 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
9 -Aug 2011
Signature
1,083.44 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund