203596 11/09/2011 a CITY OF CARMEL, INDIANA VENDOR: 365792 Page 1 of 1
,4� ONE CIVIC SQUARE QUICK SUPPLY CHECK AMOUNT: $175.31
+a CARMEL, INDIANA 46032 130 S GENERAL BRUCE DRIVE
TEMPLE TX 76501 CHECK NUMBER: 203596
CHECK DATE: 1119/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4238000 37704 175.31 SMALL TOOLS MINOR E
Quick Supply (QSN)
1 S General Bruce Drive
Temple, TX 76501
254 771 -2471
Invoice
Sold;To SHIPA70'
Carmel Clay Parks Recreation 317 5734026 Lindsay Willard 317 573 -4026
Administrative Offices Monon Community Center
1411 E. 116th Street 1235 Central Park Drive East
Carmel IN 46032 Carmel IN 46032
dkoepper @carmelclayparks.com dkoepper @carmelclayparks.com
Order Date: 20 -Oct -2011
ORDER NO.:
REF. NO.: 37704
Customer ID: 36105
PO Number: 20555
<.,z 2-1 C)c-4
Shipped -via ,:.m'- PaymentMethc�: �_PO Last4digits
'UNIT
SKU DESCRIPTION ORDERED: ,SHIPPED PRICE TOTAL
402KL Health O Meter 402KL Physicians Scale 1 1 $145.00 $145.00
Subtotal $145.00
Shipping $30.31
Sales Tax $0.00
Total $175.31
PO 20555
"1011
Purchase
Description
P.O. a �5S5 P ore
O.L. 1 [�G to �I �}Z3�6
Budget r�Y Lk. "tDi MkAm !F
Line Descr
Purchaser Date--
Approval
Thanks for your order!
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.
Quick Supply Terms
130 S General Bruce Drive
Temple, TX 76501
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/20/11 37704 Mechanical scale 20555 175.31
Total 175.31
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.
Quick Supply Allowed 20
130 S General Bruce Drive
Temple, TX 76501
In Sum of
175.31
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #rFITLE AMOUNT Board Members
Dept
1096 -21 37704 4238000 175.31 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
3 -Nov 2011
Signature
175.31 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund