167370 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00350404 Page 1 of 1
ONE CIVIC SQUARE KELTNER ASSOCIATES, INC CHECK AMOUNT: $859.83
�4 CARMEL, INDIANA 46032 520 W CARMEL DRIVE
CARMEL IN 46032 CHECK NUMBER: 167370
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356001 132384 859.83 UNIFORMS
t:
a
o Q Lockbox R REMITTANCE STUB
P.Q. Box 11588
Fort Wayne, IN 46859 -15$8 INVOICE ltner &Associates
id!NtR. 317 844 -0510
12/17/06
Invoice date
VIA U 3.L i f 33 2UU-L C'X 31 7..i3 -YUUS s
Customer H Invoice 132384
Carmel Street Department
D Carmel Street Department
1442 Attn: Jim Hobbs Order# 102215
Attn Tim Hobbs T 3400 W. 131st Job
Job r 3400 W. 131st
o Westfield IN 46074
o Westfield IN 46074 Via UPS GroundTrak Carmel Street
102215
FOB Factory Customer
Unit Customer Po Salesperson Order date Invoice date Date shipped Invoice Customer# 1442
0 18748 34 Chuck Ford 12/16/08 12/17/08 O1J06 09 132384 34 4P Salesperson
Ordered Shipped Qty BO Item Description Price Per Amount
55 55 S3L -D4 2 POCKET HI -VIS VEST LIME 15.300 EA 841.50
L -XL18 XXL -XXXL 36, 5XL
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C> Terms Net 34 PLEASE PAY Total due 859.63
Tax# 003121550 841.50 0.00 18.33 0.00 THIS AMOUNT $59.83
Sub fatal Insurance Sh /Hdl Sales tax Total
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Any ernwrd n0 pard w thin30 MYS will ne assessed a finance rtrarga d a'
15%prnon lv
lh, 18% per year_ Fure orders vn-1 be held it ao unt is past due. C USTOME R INV OICE
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.
A
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/17/08 132384 $859.83
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
VO UCHER NO. WARRANT NO.
ALLOWED 20
Keltner, Inc
IN SUM OF
520 W. Carmel Drive
Carmel, IN 46032
$859.83
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 132384 43- 560.01 $859.83 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
Wednesday, December 17, 2008
Stre t ommissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund