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169501 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 00351599 Page 1 of 1 ONE CIVIC SQUARE KOHL'S DEPARTMENT STORES CHECK AMOUNT: $312.90 CARMEL, INDIANA 46032 N56 W17000 RIDGEWOOD DRIVE ATTN PURCHASE ORDER REC DEPT CHECK NUMBER: 169501 MENOMONEE FALLS WI 53051 CHECK DATE: 3/4/2009 DEPARTMENT 710' ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 021609 195.56 OTHER EXPENSES 651 5023990 021609 117.34 OTHER EXPENSES a }q y 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 351599 KOHL'S DEPARTMENT STORES Purchase Order No. N56 W17000 Ridgewood Drive Terms Attn: Purchase Order Receivabl Due Date 2/23/2009 Menomonee Falls, WI 53051 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/23/2009 021609 $117.34 hereby certify that the attached invoice(s), or bill(s) is (are) true and :orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 Date Officer l,OUCHER 095112 WARRANT ALLOWED X51599 IN SUM OF KOHL'S DEPARTMENT STORES N56 W17000 Ridgewood Drive Attn: Purchase Order Receivabl Menomonee Falls, WI 53051 G;armel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members. PO INV ACCT AMOUNT Audit Trail Code 021609 01- 7200 -07 $117.34 Voucher Total $117.34 Cost distribution ledger classification if claim paid under vehicle highway fund MILWAUKEE,WI 02 -16 -09 12:25P 0084/0026/1639/6 1150XXX ID# 999 9783- 9087 7986- 9915- 7383 -6097 Merchandise 039307738132 31.99 4 Merchandise 052177073271 31.99 4 Merchandise 052177098731 31.99 4 Merchandise 039307604604 31.99 4 Merchandise 039307704854 31.99 4 Merchandise 039307738118 31.99 4 Merchandise 039307738088 31.99 4 Merchandise 083624854822 24.99 4 Merchandise 039307091527 31.99 4 Merchandise 052177204989 31.99 SUBTOTAL 312.90 00031201550010 T1= 0.00 7.0% TAX 0.00 TOTAL 312.90 PO VOUCH 1170 312.90 ITEM IS NOT TAXABLE P.O. NUMBER: REMITTANCE TO BE PAID BY CHECK ONLY KOHL'S DEPARTMENT STORES N56 W17000 RIDGEWOOD DRIVE MENOMONEE FALLS, WI 53051 ATTN: PURCHASE OR D R R CEIVABLE DEPT l y 111111 Illillllllillllill IIIIIIIIIIIIIIIII III I IIII I Illlll l llill l 11 THANK YOU FOR SHOPPING AT KOHL'S 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 351599 KOHLS DEPARTMENT STORES Purchase Order No. N56 W17000 Ridgewood Dr. Terms Attn: Purchase Order Receivabl Due Date 2/23/2009 Menomonee Falls, WI 53051 Invoice Invoice Description Date Number (or note attached invoice(s) or WIN) Amount 2/23/2009 021609 $195.56 hereby certify that the attached invoice(s), or bill(s) is (are) true and orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 Date Officer JGUCHER 091232 WARRANT,# ALLOWED 351599 IN SUM OF <OHLS DEPARTMENT STORES X156 W17000 Ridgewood Dr. Vin: Purchase Order Receivabl A- nomonee Falls, WI 53051 7 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members 'O INV ACCT AMOUNT Audit Trail Code 021609 01- 6200 -07 $195.56 0 1 \v 1 Voucher Total $195.56 Cost distribution ledger classification if claim paid under vehicle highway fund