172511 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
0 ONE CIVIC SQUARE RED WING SHOE STORES INC CHECK AMOUNT: $269.99
c. CARMEL, INDIANA 46032 63653 E 82ND ST
•y, oN INDPLS IN 46250 CHECK NUMBER: 172511
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM OUNT DESCRIPTION
2201 4356003 270 269.99 SAFETY ACCESSORIES
Original invoice
BILL TO REMIT TO
ATTN: BONNIE CALLAHAN Red Wing Shoe Store
CARMEL CITY STREET DEPT Castieton Village
3400 W 131ST ST 6653 East 82nd St.
WESTFIELD, IN 46074 Indianapolis, IN 4625011577
(317) 577 -0760
Invoice Number Invoice Date Terms Description
510000002710 04/28/2009 Net 30
Ticket Date Purchased By Other Information Item_ Amount
00051023993 04/20/2009 VANWIlVKLE, JEFF 02412E3100 269.99
Total $269.99
Net Total $269.99
Total Merch $269.99
Customer Tax $0.00
Maj. Acct. Tax $0.00
Message: Total Charges $269.99
Customer Payment $0.00
Maj. Acct. Payment $0.00
Total Due $269.99
Date Due 05/28/2009
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 invoices) or bill(s))
04!20109 5100000002710 $269.99
a
I 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. WARRA NO.
Red Wing Shoe Store ALLOWED 20
IN SUM OF
6653 E. 82nd Street
Indianapolis, IN 46250 4577
$269.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO #1 Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members
2201 5100000002710 43- 560.03 $269.99 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
hursd y, Ma 2009
Street Commissioner
le :fnrn�ssloner
Cost distribution ledger classification if
claim paid motor vehicle highway fund