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159601 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 361204 Page 1 of 1 ONE CIVIC SQUARE SHUMSKY i CHECK AMOUNT: $701.90 CARMEL, INDIANA 46032 PO BOX 634934 CINCINNATI OH 45263 -0934 CHECK NUMBER: 159601 CHECK DATE: 5114/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4239099 K017239 350.95 OTHER MISCELLANOUS 1125 4239000 K017239 350.95 MISCELLANEOUS SUPPLIE r PAGE: 1 Mail Payment To: (:Zs P.O. Box 634934 Cincinnati, OH 45263 -4934 I V V®ICE PEMNU Phone: 937 223 -2203 K017 2 3 9 Outside Ohio Toll free: 800 326 -2203 Fax: 937 221 -7834 Sold To: #45464 Ship To: #45464 CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATION ATT: Lindsay Holajter ATT: Lindsay Holajter 1411 E 116TH ST 1411 E 116TH ST CARMEL,IN 46032 CARMEL,IN 46032 I INVOICE DATE INVOICE I CUSTOMER P.O. DATE SHIPPED SHIPPED VIA TERMS 04 -24 -08 KO17239 L.HOLAJTER 04 -21 -08 UPS GROUND NET 15 QUANTITY QUANTITY ITEM DESCRIPTION UNIT AMOUNT ORDERED SHIPPED NUMBER PRICE 1 1 EA TC4 6 4 -SIDED 6 TABLE COVER WITH 341.85 3 41.8 5 2 -COLOR IMPRINT (THE MONON CENTER LOGO) 1 1EA TC4 6 4 -SIDED 6' TABLE COVER WITH 341.85 3 41.8 5 2 -COLOR IMPRINT (CARMEL CLAY PARKS RECREATION) I I zs) z 3 av J I.�; s., 34 l g s APR 2 R zoos 10 1 1 71 1 Z- 0 -1 311 BY:- L�. �lsl� Subtotal Deposit 0 0 0 Credit Card 0 ]7Ta x Total Gift Cert. S&H Since careful inspection at the factory often results in some imprinted pieces being disregarded, it is understood that an 1m Fn u, or�i 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. Payment Stub To pay by credit card: M/C VISA Credit card Exp Cardholder Name: Mail Payment To:Shumsky Cust Name: CARMEL CLAY PARKS RECREATION P.O. Box 634934 Cust Acct# 45464 Cincinnati, OH 45263 -4934 Invoice K017239 Total: $701.90 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. Shumsky Terms P.O. Box 634934 Cincinnati, OH 45263 -4934 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/24/08 K017239 Table Covers 350.95 4/24/08 K017239 Table Covers 350.95 Total 701.90 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. Shumsky Allowed 20 P.O. Box 634934 Cincinnati, OH 45263 -4934 In Sum of 701.90 ON ACCOUNT OF APPROPRIATION FOR 101 General 104 Program PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 K017239 4239000 350.95 1 hereby certify that the attached invoice(s), or 1047 K017239 4239099 350.95 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 12 -May 2008 Signature 701.90 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund