206436 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 361204 Page 1 of 1
ONE CIVIC SQUARE SHUMSKY
CARMEL, INDIANA 46032 PO BOX 634934 CHECK AMOUNT: $1,714.83
,o CINCINNATI OH 45263 -4934 CHECK NUMBER: 206436
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4356005 N129778A 54.83 PARTICIPANT CLOTHING
1125 R4356005 30285 N129778A 1,660.00 T SHIRTS
PAGE: 1 Mail Payment To:
hums P.O. Box 634934
prP EfflNETr� Cincinnati, OH 45263 -4934 l ��T�
Phone: 937- 223 -2203 N12 9 7 7 8A
Outside Ohio Toll free: 800 326 -2203 D
Fax: 937 221 -7834
JAN 2 0 2012
Sold To: #45464 Ship To: #45464 ]BY
CARMEL CLAY PARKS RECREATION THE MONON CENTER
ATT: DAWN KOEPPER ATT: DANA DAVIS
1411 E 116TH ST 1235 CENTRAL PARK DRIVE EAST
CARMEL,IN 46032 UNITED STATES CARMEL,IN 46032 UNITED STATES
INVOICE DATE INVOICE CUSTOMER P.O. DATE SHIPPED SHIPPED VIA TERMS
01 -17 -12 N129778A 30285 01 -05 -12 UPS" GROUND NET 30
QUANTITY QUANTITY ITEM DESCRIPTION UNIT AMOUNT
ORDERED SHIPPED NUMBER PRICE
300 300EA 29M JERZEES 50/50 HEAVYWEIGHT BLEND 4. 1,332.00
TEES W/ 2 LOCATIONS OF IMPRINT
COLOR: SAFETY GREEN
SIZE: 75/S, 75/M, 75/L, 75 /XL
25 25EA 29M JERZEES 50150 HEAVYWEIGHT BLEND 7.12 178.00
TEES W/ 2 LOCATIONS OF IMPRINT
COLOR: SAFETY GREEN
SIZE: 25 /XXL
6 6EA SET 6VrOff.RGE 2 0. 0 0 120.00
V
Description auinuIS�, T-a TA
stwo0. b o -'i P.O. 30285 P ore) q 2011
54• G.L. 1125 435
Budget
Line Descr l pANt CWyT&*IN4
Purchaser Date
Appr oyal Date
Subtotal Deposit 0 0 0 Credit Card 0 0 0 Tax Total
Gift Cert. Q QQ S &H 84.83 0.00 $1,714,831
Since careful inspection at the factory often results in some imprinted pieces being disregarded, it is understood that an underrun or overrun of up to
10% to be billed pro -rata, is acceptable by the customers. Quoted prices do not include shipping charges or any applicable taxes. All claims must be
made within 10 days after shipment. No returns can be made without our permission F.O.B. ORIGIN. Invoices not paid within our terms may be
subject to a 1 per month, 18% annum finance charge.
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.
361204 Shumsky Terms
P.O. Box 634934
Cincinnati, OH 45263 -4934
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/17/12 N129778A Volunteer T-shirts 30285 1,660.00
1/17/12 N129778A Volunteer T- shirts 54.83
Total 1,714.83
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.
361204 Shumsky Allowed 20
P.O. Box 634934
Cincinnati, OH 45263 -4934
In Sum of
1,714.83
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. CCT#ITITLE AMOUNT Board Members
Dept
30285 F N129778A 4356005 1,660.00 1 hereby certify that the attached invoice(s), or
1125 N129778A 4356005 54.83 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
9 -Feb 2012
Signature
1,714.83 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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