205516 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 360196 Page 1 of 1
ONE CIVIC SQUARE KIEFER ASSOCIATES
CARMEL, INDIANA 46032 1700 KIEFER DRIVE CHECK AMOUNT: $91.65
ZION IL 60099
CHECK NUMBER: 205516
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 I1768071 91.65 GENERAL PROGRAM SUPPL
Print Date: 12/21/2011 Page: 1 of 2
INVOICE 11768071
Address: 1700 KIEFER DR
ZION IL 60099 -5105
United States
1xi
Phone: +1- 847 872 -8866
Toll Free Phone: 800 323 -4071 13
Fax: +1- 847 746 -8888 fm
Adolph Kiefer Associates Email: eSales @kiefer.com
Website: www.kiefer.com nEC 2 7 2011
BILL TO: SHIP TO: I
Accounts Payable Brooke Tafflinger BY Carmel Clay Parks Recreation Carmel Clay Parks Recreation
1411 East 116th Street 1235 Central Park Drive East
Carmel IN 46032 PO #MC002386
United States Carmel IN 46032
United States
INVOICE NUMBER INVOICE DATE CUSTOMER. NUMBER CUSTOMER NAME
117.68071 2611'-"": 9549779 Accounts Payable
PAYMENT TYPE SHIP111EN t TYPE CARRIER BILL TO EMAIL
Payment;on Accounts C. LISPS FedEx,'.
ORDER NUMBER ORDER DATE SHIPMENT _NUMBER SHIPMENT DATE
0238050 12/2 S323954; 12/21/2011
CUSTOMER PO SHIP TO EMAIL TRACKING NUMBER
MC002386 364670250130199
S.No. Item Number Item Name Promo. Quantity Price Extended Price
Code
1 629700 KIEFER MESH GYM 0119 10.00 4.00 40.00
BAG
2 690026.131ue KIEFER DYNAMO 0119 1.00 3.95 3.95
KIDS SWIM
GOGGLE /KIEFER
DYNAMO KIDS
SWIM GOGGLE.Blue
3 6900261ight Blue KIEFER DYNAMO 0119 1.00 3.95 3.95
KIDS SWIM
GOGGLE /KIEFER
DYNAMO KIDS
SWIM GOGGLE.Light
Blue
<<f
4 690026.Pink KIEFER DYNAMO 0119 1.00 3.95 3.95
KIDS SWIM
GOGGLE/KIEFER
DYNAMO KIDS
SWIM GOGGLE.Pink
5 690001.Clear KIEFER SPRINTER 0119 2.00 3.95 7.90
SWIM GOGGLE
A/F /KIEFER
SPRINTER SWIM
GOGGLE A/F.Clear
6 690001.Smoke KIEFER SPRINTER 0119 1.00 3.95 3.95
SWIM GOGGLE
A/F /KIEFER
SPRINTER SWIM
GOGGLE A/F.Smoke
8ql �5 7 810487.Yellow KIEFER MAUI DIVE 0119 1.00 12.95 12.95
J MASK/KIEFER MAUI
Purchase'' DIVE MASK.Yellow
Description
P.O. o [»3 E& P cr F Total Item Price 76.65
5 Shipping 15.00
G.L. I Dq� -7 o y� 3�0� i
g„ •k�t Total Discount 0.00
Line Descr cq.e ��Q PCO a L-
Total Shipping and Handling Charges 15.00
Purchaser Date
Approval k Date b Total Non Freight Surcharge 0.00
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.
360196 Adolph Kiefer Associates Terms
1700 Kiefer Dr
Zion, IL 60099 -5105
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/21/11 11768071 Swim lesson supplies 91.65
Total 91.65
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.
360196 Adolph Kiefer Associates Allowed 20
1700 Kiefer Dr
Zion, IL 60099 -5105
44 In Sum of
91.65
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -70 11768071 4239039 91.65 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
11 -Jan 2012
V�fi myw
Signature
91.65 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund