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171717 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 359457 Page 1 of 1 ONE CIVIC SQUARE AMERICAN DRY GOODS CHECK AMOUNT: $502.99 CARMEL, INDIANA 46032 PO BOX 790051 ST LOUIS MO 63179-0051 CHECK NUMBER: 171717 CHECK DATE:' 4/29/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION ,1207 4356006 88272 251.82 GOLF SOFTGOODS 1207 4356006 88420 251.17 GOLF SOFTGOODS A ka, INV PAGE INVOI;GF AMERICAN DOW GOODS 01 B8272 P.O. BOX 79 0051 INVOICE DATE St Louis, MO. 63179 -0051 04 4/15/Oq TELEPHONE: 800- 822 -2708 REMIT TO: P.O. BOX 790051 FAX: 800 822 -2709 ST. LOUIS, MO 63179 -0051 ASI 35493 OF TTY O GARMEL S CITY F H C ITY OF CARMEL I3 A /LRCiOKSHTRE G. C. I TUBA /BROOKSHIRE G. C. A T TN: PAUL BLOCKOMS ATTN: PAUL. BLOCKOMS T 12120 i?ROOKSHTRE PKWY j;T 12120 BROOKSHI PKWY 'O CA ?MEL IN 4f�0 CARMEL.., .46033­­­-----_, ORDER ACCOUNT SALES- YOUR PURCHASE DER DATE MAN F.O. F SHIP VIA TERMS NUMBER E� NUMBER, ORDER NUMBER BOURBON I i 696 7 1/14/0`x': 46750' 405 030209 UPS GROUND P f NE 30 QTY SHIP a ~,ITEM NUMBER DESCRIPTION' COLOR f3 UNIT:PRICE EXTENDED PRICE e e I 6 ADG400 LADIES SOLID CLIP ON VI� WHITE 6.75 40.:50 6 ADG400 LADIES SOLID CLIP PN VI BLACK 6. 75 40.50 j g ADG400 LADI CLIP ON VISOR LEMON 6.75 40.50 ADG401 s LADIES 2 TONE CLIP ON V BLK /WHITE 6.75 40.50 j br ADG401 LADIES 2 TONE CLIP ON V BLK /KHAKI 6. 75 40.50 s ADG401 LADIES TWO TONE CLIP VS LT BLUE/W1 6.75 40.50 I v i i I c i j 1 RE IL I rj APR 19 2009 I f BY: i i E WEIGHT LBS. SALE AMOUNT 243 00 c. CARTONS FREIGHT 8.8 ORDER COMPLETE 88272 PAY THIS INVOICE NO. c ALL CLAIMS MUST BE MADE WITHIN 10 DAYS OF RECEIPT OF GOODS. NO RETURNS 'THE GOODS COVERED IN THIS INVOICE WERE PRODUCED IN COMPLIANCE WITH WITHOUT WRITTEN CONSENT. ALL CORRESPONDENCE TO BE MADE DIRECTLY TO THE FAIR LABOR STANDARDS ACT OF 1938." CUSTOMER COPY AMERICAN DRY GOODS, P.O. BOX 539/ #1 PARAMOUNT DRIVE, BOURBON, MO 65441 INVOICE N PAGE ,o►MF -P lC,� N DRY GOODS 01 .4. P.O. BOX 790051 INVOICE DATE St. Louis, MO. 63179 -0051 04 4/20/09 TELEPHONE: 800 822 -2708 REMIT TO: P.O. BOX 790051 FAX: 800 822 -2709 ST. LOUIS, MO 63179 -0051 ASI 35493 S CITY OF CARMEL H CITY OF CARMEL L UA /BROOKSHIRE G. C. I DBA /BROOKSHIRE G. C. D ATTN: PAUL BLOCKOMS P ATTN: PAUL BLOCKOMS T 12120 BROOKSHIRE PKWY T 12120 BROOKSHIRE PKWY C.ARPIEL`I.N 46033._ CARMEL IN 46033 ORDER ACCOUNT SALES- YOUR PURCHASE F.O.B. NUMBER ORDER DATE NUMBER M A N O NUMBER SHIP VIA BOURBON TERMS 70336 3/04/09 46750 405. UPS GROUND PREPAID F NET 30 OTY SHIP ITEM NUMBER DESCRIPTION COLOR UNIT PRICE EXTENDED PRICE DZ EA I 12 IADG26`� LADIES PONYTAIL CAP LAKE /MEL 6.75 81.00 12 IADG265 LADIES PONYTAIL CAP BLK /STN 6.75 51.00 i 1 2 I ADG267 LADIES LEGION CAP KHAKI 6.75 81.00 I I i I I I I I 4A I I i I i i I 1 WEIGHT 10 LBS. SALE AMOUNT 243. 1 CARTONS FREIGHT 1 ORDER COMPL.ETE 58420 PAY THIS AMOUNT 251.17 INVOICE NO. ALL CLAIMS MUST BE MADE WITHIN 10 DAYS OF RECEIPT OF GOODS. NO RETURNS THE GOODS COVERED IN THIS INVOICE WERE PRODUCED IN COMPLIANCE WITH WITHOUT WRITTEN CONSENT. ALL CORRESPONDENCE TO BE MADE DIRECTLY TO THE FAIR LABOR STANDARDS ACT OF 1938." CUSTOMER COPY AMERICAN DRY GOODS, P.O. BOX 53941 PARAMOUNT DRIVE, BOURBON, MO 65441 n n Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An 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. Payeee �1f�G4.J �2y 1o0� Purchase Order No. Terms //)G Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) i'o �a7 s 6_4 �a o Joe Total 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 F IN SUM OF Ln .9 9 ON ACCOUNT OF APPROPRIATION FOR C 41 ";f Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or --W o Z -Q(, bill(s) is (are) true and correct and that the /,261 S 8��O 54;6-06 j materials or services itemized thereon for which charge is made were ordered and received except 20 5/ Sig -ar Cost distribution ledger classification if Title claim paid motor vehicle highway fund