169594 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
o, tiF ONE CIVIC SQUARE RED WING SHOE STORES INC
CARMEL, INDIANA 46032 6653 E 82ND ST CHECK AMOUNT; $847.45
INDPLS IN 46250 CHECK NUMBER: 169594
CHECK DATE: 3/412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5025990 847.45 OTHER EXPENSES
Original Invoice
BILL TO REMIT TO
ATTN: LISA KEMPA Red Wing Shoe Store
CITY OF CARMEL WATER DIST Castleton Village
3450 W. 131 STREET 6653 East 82nd St-
WESTFIELD, IN 46074 Indianapolis, IN 46250-4577
(317) 577 -0760
Invoice Number Invoice Date Terms Description
510000002602 02/09/2009 Net 30
Ticket Date Purchased By Other Information Item Amount
00051022825 01/09/2009 MORGAN, TRENT PO#:TRENT' 02240D 110 Z3.
Total ill 43.99
Net Total 43.99
00051022826 01/0912009 COOKSEY, SHAWN PO#:SHAWN 02240D 095 43:99
Total $143.99
Net Total $1 9.Q
00051022829 01/09/2009 JONES, DARREN PC#{:DARREN 02239D 095
Total $148.49
Net Total 148
0005IO22851 01/10/2009 FROLICK, JEFF PO#:JEFF 05632M 115 134.99
Total $134.99
Net Total $134.9
00051023111 01/29/2009 BECK, MICAH PO4:01 -29 -09 05526M 105 25.99
Total $125.99
Net Total $125.99
00051023121 01/3012009 BELL, WILLIAM PO#:01302009 06630D 120 125.99
Total 1,2&99 125.99
Net Total
00051023189 02/04/2009 RANSFORD, BRETT PO#:RWSS051 02225D 095 1" 7.49
Customer Tax 0.52
Total $158.01•
Customer Payment $8.04
Net Total $150'40
Total Merch $980.93
Customer Tax $0.52
Maj. Acct. Tax $0.00
Message: Total Charges $981.45
Customer Payment $8.01
Maj- Acct. Payment $0.00
Total Due $973.44
Date Due 03/11/2009
i
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
264001
RED WING SHOE CO. Purchase Order No.
6653 E 82nd St. Terms
Indianapolis, IN 46250 Due Date 2/19/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/19/2009 5100000026( $847.45
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
s/5�.��,,,.
Date Officer
VOUCHER 091176 WARRANT ALLOWED
264001 IN SUM OF
RED WING SHOE CO.
6653 E. 82nd St.
i
Indianapolis, IN 46250
0
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
51000000260 01- 6200 -06
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund