173004 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
ONE CIVIC SQUARE RED WING SHOE STORES INC
CARMEL, INDIANA 46032 6653E82NDSr CHECK AMOUNT: $404.98
iNDPLS IN 46250 CHECK NUMBER: 173004
CHECK DATE: 5/27/2009
DEP ARTMENT ACCOUNT PO NUMBER INVOICE NU AMO DESCRIPTION
2201 4356003 2731 404.98 SAFETY ACCESSORIES
Original Invoice
BILK TO REMIT TO
ATTN: BONNIE CALLAHAN Red Wing Shoe Store
CARMEL CFfY STREET DEPT Castleton Village
3400 W 131ST ST 6653 East 82nd St.
WESTFIELD, IN 46074 Indianapolis, IN 4625011577
(317) 577 -0760
Invoice Number Invoice Date Terms Description
510000002731 05/15/2009 Net 30
Ticket Date Purchased B Other Information Item Amount
00051024090 04/29/2009 HOBBS, JIM 02235D 115 134.99
Total $134.99
Net Total $134.99
00051024231 05/08/2009 COFFEY, TIM 02412E3130 269.99
Total $269.99
Net Total $269.99
Total Merch $404.98
Customer Tax $0.00
Maj. Acct. Tax $0.00
Message: Total Charges $404.98
Customer Payment $0.00
Maj. Acct. Payment $0.00
Total Due $404.98
Date Due 06/14/2009
1.
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))
05/15/09 5100000002731 $404.98
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
Cleric- Treasurer
VOUCHER NO. WARkANT NO.
ALLOWED 20
Red Wing Shoe Store
IN SUM OF
6653 E. 82nd Street
Indianapolis, IN 46250 -4577
$404.98
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 5100000002731 43- 560.03 $404.98 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
Thursday, May 21, 2009
i
Street Commissioner';
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund