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Home My WebLink About206604 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 00352624 Page 1 of 1 ONE CIVIC SQUARE MARK BAUMGART CHECK AMOUNT: $300.00 CARMEL, INDIANA 46032 C/O STREET DEPT CARMEL IN 46032 CHECK NUMBER: 206604 CHECK DATE: 2/28/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4356001 C291 -05717 300.00 UNIFORMS 002763 DEAR MARK BAUMGART MARK BAUMGART 3040 E 236TH ST jcp.com Summary 46034 Order Summary/ 1 -800- 222 -6161 317 758 -1620 Thank you for shopping jcpenney. Invoice No. C291- 05717 Date Invoiced February 21, 2012 Shipped via UPS jcpenney Store 0218-8 Qty Item Number Item Description Price Tax For Office Use Only: 6 RN5834013 560 Jeans -Xt 42 In 36 Stnwsh 300.00 21.00 01 6 A .00 Merchandise total 300.00 Tax on mdse 7.00% 21.00 Invoice total 321.00 Notify customer at 317 -758 -1620. CUST ORDER# 2012 -0526- 2049 -9940 julia.baumgart@gmail.com To track the shipping status of your order, visit our order status page at: http://www.jcp.com/jcp/accountservices.aspx 321.00 has been char ed to your VISA account. °Exchanges Returns We hope everything is 100% satisfactory. If something is not right, please use this form for Exchanges or Returns. Instructions and Reason Codes are on the other side. Invoice No. 0291 -05717 Date Invoiced February 21, 2012 Shipped via UPS jcpenney Store 0218 -8 Return Code Qty Item Number Item Description Price Tax For Office Use Only: 6 RN5834013O 560 Jeans -Xt 42 In 36 Stnwsh 300.00 21.00 01 6 A .00 Merchandise total 300.00 Tax on mdse 7.00% 21.00 Invoice total 321.00 01B1628G1 317 758 -1620 Terms VISA 3626 1Z8801520315103979 MARK BAUMGART RETURN LABEL 3040 E 236TH ST CICEROIN 46034 jcpenney FULFILLMENT CENTER Columbus, OH 43232 -4730 pol Happy Returns. Any item, anytime, anywhere. It's that simple. With A Receipt Even exchange or receive a full refund of the purchase price on the original method of payment. With A Gift Receipt Even exchange or refund at the gift receipt price in the form of a jcp gift card. Without a Receipt Even exchange or refund at the current retail price issued in the form of a jcp gift card. Warranted Items Specific instructions for items being returned for reasons covered by a jcpenney or Manufacturer's warranty have been included in the package with each warranted item. If you have additional questions, call CUSTOMER CARE AT 1- 800 933 -7115. If an item is unsatisfactory for reasons not covered by warranty and you wish to return it, bring the item and this form to your most convenient jcpenney. REASON CODES: 11 Damaged 51 Not as ordered or advertised 12 Defective material, workmanship 52 Changed mind, did not like If a part is missing please call 1- 800 933 -7115. Order by: (Please make any corrections here.) Ship to: (Only if different from Ordered By) J c enne Address is: t Home I Business Today's Date Address is: Home Business p y First name Initial Last Order Form First name Initial Last Company Floor /Suite /Department Company Floor /Suite /Department Address (No P.O. Boxes) Building /Apartment Number Address (No P.O. Boxes) Building /Apartment Number ORDER ONLINE Cit state Zip Code City State Zip Code Jcp.com Daytime ]Home[ Business Daytime I ]Home Business Page Item Item Number (measure Color /Pattern How One For Monogram Total N t be sure) Number /Name Many One etc. Price ORDER BY PHONE 1- 800 222 -6161 Call anytime, 7 days a week FOR CREDIT ORDERS Complete this section: FOR CASH ORDERS Complete this section: Total Price Enter the Check only one box. Enter your account number and sign below. Shipping MERCHANDISE TOTAL and ]jcpenney Regular Charge ]jcpenney Major Purchase Handling charges AMOUNT FOR SHIPPING HANDLING for the total I Visa MasterCard American Express I Discover Card SALES TAXES merchandise value. TOTAL PAYMENT Expiration date: Month Year Please pay by check or money order in U.S. dollars. Sorry we do not accept C.O.D. orders. Do not send currency or stamps. Include payment for shipping handling. Signature (Required for all charge orders) Date For orders to Alaska and Hawaii and all USA Possessions and Territories, we will ship via Parcel Post unless you indicate Air Parcel Post here. Air Parcel Post 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)) 02/21/12 C291 -05717 $300.00 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. ALLOWED 20 Mark Baumgart IN SUM OF 3040 E. 236th Street Cicero, IN 46034 $300.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 2201 C291 -05717 43- 560.01 $300.00 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 Mon F Gary 27, 2012 Street Commis i er C�ract (`r.rn oc� n�. Title Cost distribution ledger classification if claim paid motor vehicle highway fund