168449 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 00352212 Page 1 of 1
ONE CIVIC SQUARE DON PAYNE INC CHECK AMOUNT: $2,536.85
CARMEL, INDIANA 46032 2809 E 56TH ST
*2 coii to.. INDIANAPOLIS IN 46220 CHECK NUMBER: 168449
CHECK DATE: 2/412009
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOU DESCRIPTION
1120 R4356002 12628 38845' 2,536.85 SERVICE PINS
'Advertising Gifts for Sales Promotion"
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292050 x® don payne, inc
ley,
2809 E, 56th Street
Indianapolis, IN 46220 (317) 257 -1536 30780
FAX (317) 257 -6480
CUSTOMER N, v Carmel Fire, Dept
59950_' w �ATTN: Denise
=Carmel Fire Dept 2 Civic Square
40165 ATM, Denise Carmel IN 46032
JOB NO. 2 Civic Square
Carmel IN 45032 r=� Best, 43ay Ppd Add
UNIT NO.? CUS i OMER P O. NO. SALESPERSON ORDER DATE INVOICE DATE- DATE SHIPPED INYOICE NO.
0 �l l Gregg Payne 12/12/08 j 0Z• /13 /09 0Z/09 38845
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OUAN:ORD....'.' 4QUAN2'SHP OUAN'.60. EMWMBER DESCRIPTION -i PRICE. c i::AftDUNT:.
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85 8,5 x.8701 -S 7 %8:', #8701 -S 16.�6 +E 1365 x.,10
37 37 "88 @1� GF 3 7- $801 -GF 27.560 E.`T 1023: p'
122 s 122 Engraving #s Years 1.. 100 �E 134.20
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'lank you for your orderd`
We Appreciate your busines
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fE s Net -10
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"Ah 2522 ".72 .0.00 11 14.13 x.00 2536.85
SUB_T,OTAL '..:r ''INS _FREIGHTMANDLING .'iSALES TAX f. i,L „4t
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any arAunt not.paid within'30 days may be assessed an ANNUAL percentage rate R We appreciate your business
f 18 Additional conditions on reverse side also apply to this invoice..
ORIGINAL INVOICE
CONDITIONS"
Rurchaser agrees to pay any sales" or use tax. Additional freight charges billed us due to audits per ICC regulations will be billed you' promptly,
No credit will be issued for returned merchandise 'Without our consent. It is understood that an underrun or'overrun of not more than 10% to be billed
pro -rata, is acceptable by the customer.
Shipping Liability: This merchandise becomes your property at'the time it is accepted by the carrier:
"A Late Payment Charge based,on maximum,ann4 percentage rate allowed by your state law will be, applied to this balance owed
under this invoice when invoice becomes past due. The purchaser agrees to pay all of the company's reasonable attorney's fees and
any collection agency fees incurred in the collection of any amount owed hereunder and not paid when due
This invoice a conditional acceptance by the seller of.the buyer's offer to purchase selier's goods, it may contain terms which differ from or add to
those contained in the buyer's purchase order and to the extent that this is the case, the seller hereby expressly conditions its acceptance of the
buyer's offer on the; buyer's assent to the additional or different -terms. fhe buyer's receipt and retention of the goods covered by this invoice shall
constitute acceptance-of any such additional or different terms. The buyer and seller agree that any contract hereby entered into has been made an`d
is to be construed according to our State Law. t
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
z
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))
38845 Service Pins $2,536.85
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
VOU NO. WA RRANT N
ALLOWED 20
Don Payne, Inc.
IN SUM OF
2809 East 56th Street
Indianapolis, IN 46220
$2,536.85
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
12628 38845 43- 560.02 $2,536.85 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
FEB 2 2009
6
6 t
I Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund