165969 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 361270 Page 1 of 1
ONE CIVIC SQUARE SUCCESSORIES LLC CHECK AMOUNT: $109.93
CARMEL, INDIANA 46032 38646 EAGLE WAY
CHICAGO IL 60678 -1386 CHECK NUMBER: 165969
CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO DESCRIPTION
1047 4239099 22249126 109.93 OTHER MISCELLANOUS
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y
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F s s� mar
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SUCCESSO LLC INVOICE
Please Remit to:
38696 EAGLE WAY
CHICAGO, IL 60678 1386
(800)535 -2773 Fax:(800)932 -9673 Date: 07/29/08 Page: 7.
(Sold To: 21506859 000 1 (Ship To: 21506859 000 I
CARMEL CLAY PARKS RECRATION CARMEL CLAY PARKS RECRATION
I EMILY RANDELL I I EMILY RANDELL
1 1911 E. 116TH STREET I 1 1911 E. 116TH STREET I
�1 CARMEL, IN 96032 -3955 I I CARMEL, IN 96032 -3955
I I I I
TERMS I Date Shipped I Sales Rep I Customer# I Our Order# I Invoice#
I NET 30 DAYS 1 07/29/08 1 002 1 21506859 139029152 -01 1 22299126 I
I I
CUSTOAIERPO# 19186 FEDID# 30- 0150021
I Q TY SHIPPED I CODE NO I DESCRIPTION I PRICE /UNIT I TOTAL AMO UNT I
1 1 1 701786 1 EO 9x11 PERSISTENCE RUNNER I 99.99 EA 1 99.99 I
1 1 1 701797 1 EO 9x11 SKYS LIMIT ALUM AWRD I 99.99 EA 1 99.99 I
1 1 1 896019 1 MULTI PRODUCT loo INSERT .00 EA 1 .00
1 1 1 896069 1 DP COMP TEAM BRIEFINGS I .00 EA 1 .00
1 1 1 896080 1 SUCCESS MAGAZINE INSERT .00 EA 1 .00 I
I I I I I I
I I I I I I
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1 1 purr�haser 'C =�Zn 4 Q Dat0 1 L •7� 1.T `2 1 7008
I Approval Date.__„
I I I I I I
I MERCHANDISE I TAX I SHIPPING I MISC TOTAL
1 99.98 1 .00 1 9.95 1 I 109.93
PLEASE PAY AMOUNT IN TOTAL COLUMN
THANK YOU
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. 19186 F
361270 Successories, LLC Date Due
38646 Eagle Way
Chicago, IL 60678 -1386
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/29/08 22249126 Plaques 109.93
Total 109.93
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.
Allowed 20
361270 Successories, LLC
38646 Eagle Way
Chicago, IL 60678 -1386 In Sum of
109.93
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 22249126 4239099 109.93 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
31 -Oct 2008
Signature
109.93 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund