173900 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 360196 Page 1 of 1
ONE CIVIC SQUARE KIEFER ASSOCIATES
CARMEL, INDIANA 46032 1700 KIEFER DRIVE CHECK AMOUNT: $666.70
a�aaa° ZION IL 60099 CHECK NUMBER: 173900
CHECK DATE: 6/24/2009
DEPARTM ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 11530180 666.70 GENERAL PROGRAM SUPPL
Print Date: 06/05/2009 Page: 1 of 1
INVOICE 11530180
Address: 1700 KIEFER DR
ZION IL 60099 -5105
United States
Phone: +1- 847 -872 -8866
ry Toll Free Phone: 800- 323 -4071
Fax: +1- 847 746 -8888
Email: eSales @kiefer.com
Website: www.kiefer.com
BILL TO: SHIP TO:
Carmel Clay Parks and Rec JUAI •r�� Carmel Clay Parks and Rec
Accounts Payable 8 200 Receiving PO #21976
1411 E 116th Street, 9 Monon Center
1235 Central Park Dr E Allison Chadwick
CARMEL IN 46032 CARMEL IN 46032
United States United States
INVOICE:NUMBEl2 INVOICE DATE ".CUSTOMER NUMBER CUSTOMER NAME
11530`180 06!0512009 0549779 Carmet,Clay Parks and Rec
PAYMENT TYPE SH IPM ENT'TYPE' ;CARRIER �BI ILL -TO.EMAIL
Payrneht�on Account Ground
ORDER NUMBER ORDER DATE SHIPMENT NUMBER SHIPMENT :DATE
030228
06/05/2009 541272 06105!2009
CUSTOMER PO SHIP EMAIL TRACKING NUMBER;
21976
..�1Z6260690300598683 1Z6260690300598692
1Z62606903005 98736 .1 °Z6260690300598709
1Z6260690300598727 1Z6260690300598718
S.No. Item Number Item Name Promo. Quantity Price Extended Price
Code
1 621008.B1ue 3 PIECE SWIM BELT 0095 15.00 13.05 195.75
AQUACEL/3 PIECE
SWIM BELT
AQUACEL.Blue
'2 650603 KIEFER BARBELL 0095 30.00 9.68 290.40
3 612323 RAID DIVING RINGS 0095 6,00 9.95 59.70
BOX OF 4
4 651001 KIEFER EGG FLIPS 0095 3.00 16.95 50.85
PKG OF 10
5 650599 MINI TUNDRA 0095 10.00 2.50 25.00
NOODLE
Total Item Price 6
Shipping 45.00
Total Discount 0.00
Total Shipping and Handling Charges 45.00
Total Non Freight Surcharge 0.00
Sales Tax (0.00% on $666.70 included.) 0.00
Grand Total 666.70
Purchase SW 1 t" 1_esc -O
Description �t r�rl t E'er
P.O.# 1 Por(v no
a.L y 7 00 -ate 22��0
Budget
Line Descr
Purchaser Date
Approval Date
3--' 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.
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
6/5/09 11530180 Swim lesson supplies 21976 666.70
Total 666.70
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.
Adolph Kiefer Associates Allowed 20
1700 Kiefer Dr
Zion, IL 60099 -5105
In Sum of
foto(c (O
66 6.70
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. CCT #/TITLE AMOUNT Board Members
Dept
1047 1 1 1530180 4239039 666.70 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
f
18 -Jun 2009
�&L
Signature
666.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
v
claim paid motor vehicle highway fund