168166 01/21/2009 F CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
.I, 0 ONE CIVIC SQUARE RED WING SHOE STORES INC
CARMEL, INDIANA 46032 6653 E 82ND ST CHECK AMOUNT: $215.98
INDPLS IN 46250
«ox CHECK NUMBER: 468166
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOU DESCRIPTION
601 5023990 510000000252 215.98 OTHER EXPENSES
Original Invoice
BILL TO REMIT TO
ATTN: LISA KRMPA Red Wing Shoe Store
CITY OF CARMEL WATER DIST Castleton Village
3450 W. 131 STREET 6653 East 82nd St.
WESTFIELD, IN 46074 Indianapolis, IN 462504577
(317) 577 -0760
Invoice Number Invoice Date Terms Description
510000002525 12/20/2008 Net 30
Ticket Date Purchased By Uther Information Item Amount
00051022231 11/17/2008 simpson, don PO#:diAins/fore 05504W2105 94.49
Total $94.49
Net Total $94.49
00051022232 11/17/2008 f1AAG, JAMES PO#:773 -2855 06630D 090 121.49
Total $121.49
Net Total $121.49
Total Merch $215.98
Customer Tax $0.00
Maj. Acct. Tax $0.00
Message: Total Charges $215.98
Customer Payment $0.00
Maj. Acct. Payment $0.00
Total Due $215.98
Date Due 01/19/2009
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 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 12/31/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12131 /200 5100000025,' $215.98
J�
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
dl
Date Officer
VOUCHER 084032 WARRANT ALLOWED
264001 IN SUM OF
RED WING SHOE CO.
6653 E. 82nd St.
Indianapolis, IN 46250 RNS'
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
51000000252 01- 6200 -06 $215.98
Voucher Total $215.98
Cost distribution ledger classification if
claim paid under vehicle highway fund