166759 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 359367 Page 1 of 1
ONE CIVIC SQUARE KELTNER INC CHECK AMOUNT: $243.19
CARMEL, INDIANA 46032 LOCKBOX R
PO BOX 11588 CHECK NUMBER: 166759
FT WAYNE IN 46859 -1588
CHECK DATE: 12/1012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4356004 128518 243.19 STAFF CLOTHING
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a
g
Lockbox R C:: Q P.O. Box 1 1588 INVOICE
Fort Wayne, IN 46859 -15
inc. 317- 844 -0510
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Customer# Ph :317- 848 -7275 Fx:317- 571 -4136 H
o P Carmel Clay Parks Recreation
1277 L Attn: Tina Hotze
D Carmel Clay Parks Recreation T 1411 East 116th Street
Attn: Tina Hotze Carmel IN 46032
Job# r 1411 East 116th Street
Carmel IN 46032 Via
97326 UPS GroundTrak
FOB Factor
Unit Customer po Salesperson Order date Invoice date Date shipped Invoice
0 34 Chuck Ford 02 15 08 03 25 08 02/15/08 F128518
Ordered Shipped Qty BO Item Description Price Per Amount
i
12 12 706 GREY SWEAT PANTS 19.070 EA 228.84
12 12 PRINTING SILK SCREENING 0.000 EA 0.00
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Purchase G
nes cripti�
P.O._/ PorF
G.L# COO Z- 2 2 l
Bud i (0 ��rl 1► GL
L SUE QEC 1 2008 aser Dn
_mvd Date i
Terms Net 30 PLEASE PAY
Tax# 0031201550 228.84 0.00 14.35 0.00 THIS AMOUNT 243.19
Sub -total Insurance Shpg/Hdlg Sales tax Total
CUSTOMER INVOICE
ACCOUNTS PAYABLE VOUCHER
�J 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.
359367 Keltner Inc. Terms
Lockbox R, P.O. Box 11588
Fort Wayne, IN 46859 -1588
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/25/08 128518 Staff uniforms 243.19
Total 243.19
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.
359367 Keltner Inc. Allowed 20
Lockbox R, P.O. Box 11588
Fort Wayne, IN 46859 -1588
In Sum of
243.19
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 128518 q ,36 6004 243.19 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
3 -Dec 2008
Signature
243.19 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund