178326 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 00350062 Page 1 of 1
`i. ONE CIVIC SQUARE SCOTT OSBORNE CHECK AMOUNT: $500.00
CARMEL, INDIANA 46032 19702 SIX POINTS ROAD
SHERIDAN IN 46069 CHECK NUMBER: 178326
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE N UMBE R AMOUNT DESCRIPTION
102 4467007 500.00 TRAINING EQUIPMENT
O
Regular Sale On -Line
Invoice 0132 041505
Date: 09/30/2009 20:14
4161 E. 96th St Cashier 0325
Indianapolis, IN, 46240 (317) 848 -1517 0325- WARREN WILLIAMS
D
S 000001 e
1
SCOTT OSBORNE i SCOTT OSBORNE
d 19702 SIX POINTS RD 19702 SIX POINTS RD
SHERIDAN I, NN 46069 r SHERIDAN I, NN 46069
r Home'." (317) 867 -0551 OSBRSCT@AOL.COM" Home: (317) 867 -0551 Cellular.(317) 710 -2321
Cellular.(317) 710 -2321 0
Special Instructions
S i Q ty Model No Descri I'D elDate S erial Number Loc !Code! Trn I'-Viai".; °Price Total
ls IN STORE PICKUP ITEMS ..........._.....,x i
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0001 11 j PN50B450 iPLASMA,SAM,50" 09/30/09; 0001I I AT 725.00 I 725.00
0002 1 NW PREMIUM SERVICE PLAN DECLINED 09/30/09 00011 1 AT j 0.00 I 0.00
0003 12 32LH2O :LCD TV,LG,32" 09/30/09 0001 I AT 395.00 I 790.00
0004 �2 i NW PREMIUM SERVICE PLAN DECLINED 09/30/09 jl 0001 I AT i 0.00 i 0.00
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Pay No Interest If Paid Within Days /Months Indicated Monthly Payments Required On Promo Purchases. Finance charges accrue at APR of up to 29.99% but
(1) promo purchase balance paid in full within Days/Months indicated (2) All minimum monthly payments on account paid when due, and (3) Account balance does not exceed credit limit.
Otherwise, promo may be terminated accrued finance charges assessed from purchase date. Standard terms apply to terminated and expired promotions, non promotional purchases and
optional charges Payments over the minimum will usually be applied to promo balances. To change this allocation, please call Customer Service. Promo purchases on existing accounts will
accrue finance charges at APR of up to 29 9 andmay- noLrecervg_full benefit-of-promo.terms�uding reduced AP-Etif_applicable,if -account In comessubjectio delinquency-prici
Than ag
Subtotal $1,515.00
Thank you. WARREN WILLIAMS
CUSTOM- ER' =C.PY
HHGregg Bankcard $775.75 TeX 106.05
s =1789 Exp xx/xx App 030778 Invoice Total $1,621.05
The merchandise described above has been inspected i 12 MO NO INTEREST MIN MONTHLY PMTS Amount Due $1,621.05
and received in good condition unless otherwise I HHGregg Bankcard $845.30
;notat on the invoice: '1789 Exp xx/xx App 030797 Amount Received $1,621.05
90 DAYS NO INTEREST MIN MONTHLY PMTS
jDelivery has been completed and no damage Change Due $0.00
;has o ccurred t o o personal prop> rt Retain this invoice for future service or returns.
I agree to comply with the Cardholder
Please save this invoice. agreement.
Thank You! f
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X
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Merchandise Received By Date
Rev. 6.0.7.125
X
Merchandise Delivered By Date
r' 0132041505
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
r'
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))
$500.00
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
Scott Osborne
IN SUM OF
$500.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 102- 670.07 $500.00 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
OrT 1 2`2009
n
1
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund