178682 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 00350432 Page 1 of 1
ONE CIVIC SQUARE EMBROIDERY PLUS
CHECK AMOUNT: $3,296.25
CARMEL, INDIANA 46032 5514 W. WASHINGTON STREET
«per INDIANAPOLIS IN 46241 CHECK NUMBER: 178682
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356001 112190 3,296.25 UNIFORMS
i
.I
Embroidery Plus Invoice
5514 W Washington St
Indianapolis, IN 46241 Date Invoice
10/9/2009 112190
Bill To
CARMEL FIRE DEPT.
2 CIVIC SQ.
CARMEL, IN 46032
P.O. No. Terms Project
Net 30
Item Qty Description Rate Amount
T- SHIRTS 432 med xlarge 6.75 2,916.00T
T- SHIRTS 72 xxlarge 7.75 558.00T
T- SHIRTS 9 xxxlarge 8.75 78.75T
DISCOUNT 513 x.50 256.50 256.50
Sales Tax 0.00% 0.00
Total $3,296.25
VOUCHER NO. WARRANT NO,
ALLOWED 20
Embroidery Plus
IN SUM OF
5514 West Washington Street
Indianapolis, IN 46241
$3,296.25
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 112190 43- 560.01 $3,296.25 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
OCT 2 6 2009
d
7
T b
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
112190 $3,296.25
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