176116 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 363256 Page 1 of 1
ONE CIVIC SQUARE AD TROPHY MFG. CORP.
1 248 -44 JERICHO TURNPIKE CHECK AMOUNT: $208.00
CARMEL, INDIANA 46032
BELLEROSE NY 11001 CHECK NUMBER: 176116
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER IN NUM AMOUNT DESCRIPTION
851 5023990 177938 208.00 OTHER EXPENSES
,L
y app
'1 ��V OC E
'y
r
Mfg. Corp.
A D T R O P H Y Page of t
P,48 -44 JERICHO TURNPIKE o BELLEROSE, NY 11001
TEL: 1 -800- 841 -6790 a (516) 352 -6161 o FAX: (516) 352 -8502 O 17793 8
E -mail: sales @adtrophy.com
CARMEL FIRE, DEPT.
SOLD ATTN. DENISE SNYDER SHIP
TO: 2 CIVIC SQUARE' TO:
CARME1., IN 460,
Invoice matte 8/6/2009 'Home Telephone Ship Vila UPS GROUND
InvolceNuniber M0 177938 Work Teflephoue (3:17) 571 622 Mail► Date 8/10/2009
Payment Method INVOICE Card) PONumber 12673
Quanthy Sttyle# Page Description Gender Figure Color Activities Price Tour
A t00 I'IT I -MS—G t8r''0 Victory G. VIC�TCRY Gtv LD RNY8 $.L.85 $185.00
I3 1
CATALOG C- AJ. OG C »0? $0.{l0 $0..00
Sub Tonal $185.013
Order Ililscao+tni<tt, $0.00
RRI i N Freight Charge $23.030
Sales Tax $0.00
Order Total $208.00
P yaaeent $0:00
ANY DWAGES MUST BE REPORTED WTtHM 15 DAYS OF RECETFr OF 'Total Due $208.00
MERCHANDISE Thank you for placing your order with axs. It you art satisfied
with our service tell others. If not toll, eta!
WS'PEC17D BY-.
`�w:� r �try:ccaraa a
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
i n invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
G
1
Total O� p
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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
AN 1
0
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund