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172321 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 360856 Page 1 of 1 F 0 ONE CIVIC SQUARE FITNESS FIXX CHECK AMOUNT: $47.25 CARMEL, INDIANA 46032 11650 LANTERN RD STE 216 FISHERS IN 46038 CHECK NUMBER: 172321 CHECK DATE: 5/13/2009 DEPARTMENT ACCOUN PO NUMBER INVOICE NUMB AMOUNT DE 1047 4350000 6198 47•.25 EQUIPMENT REPAIRS M Y FITNESS FI Invoice 11650 Lantern Rd., Ste 216 Fishers, W46038 (317)4 DATE INVOICE# 4/23/2009 6198 BILL TO SHIP TO Cannel Clay Parks and Recreation Carmel Clay Parks and Recreation 1235 Central Park Drive East 1235 Central Park Drive East Cannel, W 46032 Cannel. LN 46032 P.O. NO. TERMS DUE DATE 421092JM Net 30 5/23 /2009 DESCRIPTION QTY RATE AMOUNT PM Discount Labor for one technician 0.25 45.00 11.25 Kevlar Belt ($6.00 /11.) 6 6.00 36.00 Q C0 g MAY 0 1009 ]BY:5..!:a Q.... All work is complete! Total I $47.25 p V 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. 360856 Fitness Fixx Terms 11650 Lantern Rd., Ste. 216 Fishers, IN 46038 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 4/23/09 6198 Repair Cybex 360 belt/fitness equipment 20776 47.25 Total 47.25 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. 360856 Fitness Fixx Allowed 20 11650 Lantern Rd., Ste. 216 Fishers, IN 46038 In Sum of 47.25 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 6198 4350000 47.25 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 7 -May 2009 Signature 47.25 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund