204009 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 00350177 Page 1 of 1
ONE CIVIC SQUARE SEARS HARDWARE
CARMEL, INDIANA 46032 PO BOX 689131 CHECK AMOUNT: $239.96
DES MOINES IA 50358 9131 CHECK NUMBER: 204009
CHECK DATE: 11/21/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238000 T219359 239.96 SMALL 'POOLS MINOR E
S a a Page 1 c 4
Sequence 9 -2169
CommercialOnW ACCOUNT NUMBER 5405 5340 0749 1408
CUSTOMER SERVICE 1- 800 -599 -9712
Account Total Available Billing Cycle Payment Minimum
Balance Credit Line Credit Closing Date Due Date Payment Due
$239.96 $5,000, $4,760 11/04/11 11/29/11 $239.96
Account.Summary
Previous Balance $0.00
Payments $0.00
Returns /Exchanges /Adjustments -$10.00
Purchases Debits $249.96
Account Balance $239.96
Purchasing Account 5405 5320 0108 0128
Current Purchases and Debits
Detail enclosed for new purch item since last statement.
Trans. Post I Sears Purchase
Date Date Purchase Location Invoice Customer PO Order Amount
10119 10119 SEARS HARDWARE 5340 FISHERS IN T219358 SHOPSTEWART $249.96
20111019005340'900R7560
Total Purchases and Debits for Account Number 5405 5320 0108 0128 $249.96
Returns /Exchanges /Adjustments
Detail enclosed for new credit items since last statement.
Trans Post Sears Purchase
Date Date Purchase Location Invoice Customer PO Order Amount
10/19 10119 SEARS HARDWARE 5340 FISHERS IN T219365 sHOPSTEwART -$10.00
20111019005340`900R7560
Total Returns/Exchanges /Adjustments for Account Number 5405 5320 0108 0128 -$10.00
Total Account Activity for Account Number 5405 5320 0108 0128 $239.96
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OE 1 M �1.x H.<
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
-Your name and account number and sent to the inquiry address on the reverse side.
The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
Sears Sequence 2 of 4
Sequence -2169
Commercial One ACCOUNT NUMBER 5405 5340 0749 1408
CUSTOMER SERVICE 1- 800 -599 -9712
�d
SEND BILLING ERROR NOTICES TO: SEND INQUIRIES TO: CALL 1 -800- 599 -9712
PO BOX 653043 PO BOX 653043 FAX 1- 800 -599 -9711
DALLAS,TX DALLAS,TX
75265 -3043 75265 -3043
Please contact us A 1 -800 -599 -9712 with account reconciliation instructions. Purchases, returns and payments made just prior to the
generation of this account statement may not appear until the generation of next month's account statement.
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
Your name and account number and sent to the inquiry address on the reverse side,
The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
PLEASE ENTER NEW ADDRESS, TELEPHONE NUMBER OR E -MAIL ADDRESS BELOW:
NAME
ADDRESS
(CITY STATE ZIP
1
HOME PHONE BUSINESS PHONE E -MAIL ADDRESS
SCOGBG00000711 Rev. 07111
Sears SEARS COMMERCIAL ONE Page 3 of 4 CITY OF CARMEL STREET DEPT
Commercial OnOIR BOX 630859 3400 W ACCOUNTS
ST PAYABLE
!RVlNG, TX 75063 -0859
CARMEL IN 46074 -8267
nc
Inf►rmatton Trarlsatiola 1f 2
Payment Due Date: 11/29/11 Purchase Location: FISHERS Statement Date: 11/04/11
Name: CITY OF CARMEL STREET DEPT Customer PO SHOPSTEWART
Invoice T219358 Invoice Amount: $249.96 Sears Order
Invoice Date: 10/19/11 Cardholder Name: CITY OF CARMEL STREET DEPT Purchase Card 5405532001080128
Ship to Address: CARMEL STREET DEPT
WESTFIELD IN
Quant :ty' SKUIDei3crtptia;n U.nit Price Total Price
wm nn-
2 00944004000 REV GRWRNCH,8PC MM $59.99 $119.98
2 00944003000 REV GRWRNCH,8PC SAE $59.99 $119.98
1 076023 SEARS HARDWARE $10.00 $10.00
Payment Address: SEARS COMMERCIAL ONE Total Price: $249.96
PO BOX 689131 Tax: $0.00
DES MOINES IA 50368 -9131 Delivery: $0.00
For Customer Service Call: 1- 800 -599 -9712 Grand Total: $249.96
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
-Your name and account number and sent to the inquiry address on the reverse side.
The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
PLEASE ENTER NEW ADDRESS, TELEPHONE NUMBER OR E -MAIL ADDRESS BELOW:
NAME
ADDRESS
(CITY STATE ZIP
HOME PHONE BUSINESS PHONE E -MAIL ADDRESS
SCOGBG00000711 Rev. 07111
Sears SEARS COMMERCIAL ONE Page 4 of4 CITY OF CARMEL STREET DEPT
Commercial OnW po BOX 630859 3400 W 131 ACCOUNTS PAYABLE
IRVING, TX 75063 -0859 CARMEL IN 46074 -8267
Inft rrnation„
Payment Due Date: 11/29/11 Purchase Location: FISHERS Statement Date: 11/04/11
Name: CITY OF CARMEL STREET DEPT Customer PO SHOPSTEWART
Invoice T219365 Invoice Amount: $10.00 Sears Order
Invoice Date: 10/19/11 Cardholder Name: CITY OF CARMEL STREET DEPT Purchase Card 5405532001080128
Ship to Address: CARMEL STREET DEPT
WESTFIELD IN
Qua "rttify.... KU /Desorption Unrt Price.. TofaLPrce
CREDIT *CREDIT MEMO
1 109076 SEARS HARDWARE -$10.00 -$10-00
Payment Address: SEARS COMMERCIAL ONE Total Price: $10.00
PO BOX 689131 Tax: $0.00
DES MOINES IA 50368 -9131 Delivery: $0.00
For Customer Service Call: 1 -800 -599 -9712 Grand Total: -$10.0()
0
I
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
Your name and account number and sent to the inquiry address on the reverse side.
The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
PLEASE ENTER NEW ADDRESS, TELEPHONE NUMBER OR E -MAIL ADDRESS BELOW:
NAME
ADDRESS
/CITY 1 r STATE ZIP
HOME PHONE BUSINESS PHONE E -MAIL ADDRESS
SCOGBG00000711 Rev. 07/11
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sears �1n
IN SUM OF
P. O. Box 689131
Des Moines, IA 50368 -9131
$239.96
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 T219359 42- 380.00 $239.96 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
Thursday, November 17, 2011
r
Street Commiss on
�jtreet C;CfJ@j&q+sSione-
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Slate 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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/19/11 T219359 $239.96
1
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