165955 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 361204 Page 1 of 1
s ONE CIVIC SQUARE SHUMSKY CHECK AMOUNT: $269.53
CARMEL, INDIANA 46032 PO BOX 634934
CINCINNATI OH 45263 -4934 CHECK NUMBER: 165955
CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
1047 4239039 K047809A 124.95 GENERAL PROGRAM SUPPL
1047 4239039 K048675A 144.58 GENERAL PROGRAM SUPPL
V
PAGE: 1 Mail Payment To:
(:j S h u m "M� ski) P.O. B ox 634934
Cincinnati, OH 45263 -4934 INV0'ICE
PEMN�
Phone: 937 223 -2203 4 K04 7 8 0 9A
Outside Ohio Toll free: 800 326- 2203pq,� tl
Fax: 937-221-7834
Sold To: #45464 Ship To: #45464
CARMEL CLAY PARKS RECREATION THE MONON CENTER EAST
ATT: TESS PINTER ATT: TESS PINTER; 100 MILE CLU
1411 E 116TH ST 1235 CENTRAL PARK DRIVE EAST
CARMEL,IN 46032 CARMEL,IN 46032
I INVOICE DATE INVOICE I CUSTOMER P.O. DATE SHIPPED SHIPPED VIA TERMS
10 -16 -08 KO47809A T.PINTER 10 -13 -08 3rd Part NET 30
QUANTITY QUANTITY ITEM DESCRIPTION UNIT AMOUNT
ORDERED SHIPPED NUMBER PRICE
100 8 8EA ADD SPONSORHIP IMPRINT TO THE 1.24 109.12
BACK OF EXISTING 100 MILE CLUB
SHIRTS
ATHLETIC GREY: VARIOUS SIZES
Purchase
Description
P.O. _KI P or
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Budget
Line Descr YC(.n s at2 0 T 2 7 2008
Purchaser
Approval Date
Subtotal Deposit 0 0 0 Credit Card 0 00 Tax Total
Gift Cert. S&H 15_83�
Since careful inspection at the factory often results in some imprinted pieces being disregarded, it is understood that an underrun or overrun of up to
10% to be billed pro -rata, is acceptable by the customers. Quoted prices do not include shipping charges or any applicable taxes. All claims must be
made within 10 days after shipment. No returns can be made without our permission F.O.B. ORIGIN. Invoices not paid within our terms maybe
subject to a 1 per month, 18% annum finance charge.
PAGE: 1 Mail Payment To:
(:]SE msky P O Box ��o�. cinnati OH OH 45263 -4934 INVOICE
a ®xE,
Phone: 937-223-2203 K048675A
Outside Ohio Toll free: 8 �220�
Fax: 937 221 -7834 0�
Sold To: #45464 Ship To: #45464
CARMEL CLAY PARKS RECREATION THE MONON CENTER
ATT: MATT LEBER ATT: MATT LEBER CORNHOLE LEA
1411 E 116TH ST 1235 CENTRAL PARK DRIVE EAST
CARMEL,IN 46032 CARMEL,IN 46032
INVOICE DATE INVOICE CUSTOMER P.O. DATE SHIPPED SHIPPED VIA TERMS
10 -23 -08 KO48675A M.LEBER "IU- 15 Uti LOCAL�ACKACz 1v E1' 3 0
QUANTITY QUANTITY ITEM DESCRIPTION UNIT AMOUNT
ORDERED SHIPPED NUMBER PRICE
22 22EA 11730 ADULT SHORT SLEEVE T- SHIRTS WITH 3.95 86.90
]-COLOR DESIGN ON FRONT
SKY BLUE: S -3; M -7; L -5; XL -7
1 1 EA SETUP CHARGE 25.00 2 5. 0 0
1 1EA PROOF: EMAIL 0.00 0.00
Purchase
Description l C n�p 4 w (tS
P.O.: 11�S�5 f
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Lin S 1
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Purchaser a e
Approval Date_LV 1
�Y. _J
Subtotal Deposit 0 Credit Card 0 0 0 Tax Total
$111.9J Gift Cert. SaH 32.68 $144.SBJ
Since careful inspection at the factory often results in some imprinted pieces being disregarded, it is understood that an underrun or overrun of up to
10% to be billed pro -rata, is acceptable by the customers. Quoted prices do not include shipping charges or any applicable taxes. All claims must be
made within 10 days after shipment. No returns can be made without our permission F.O.B. ORIGIN. Invoices not paid within our terms may be
subject to a 1 per month, 18% annum finance charge.
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.
361204 Shumsky Terms
P.O. Box 634934
Cincinnati, OH 45263 -4934
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/16/08 K047809A 100 Mile club Logo Addition 124.95
10/23/08 K048675A Cornhole T Shirts PO 19551 F 144.58
Total 269.53
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
361204 Shumsky Allowed 20
P.O. Box 634934
Cincinnati, OH 45263 -4934
In Sum of
269.53
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 K047809A 4239039 124.95 1 hereby certify that the attached invoice(s), or
1047 K048675A 4239039 144.58 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
I
31 -Oct 2008
Signature
269.53 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund