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206972 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 026625 Page 1 of 1 ONE CIVIC SQUARE BOB BLOCK FITNESS EQUIP CARMEL, INDIANA 46032 8128 CASTLEWAY COURT WEST CHECK AMOUNT: $505.20 INDIANAPOLIS IN 46250 „a CHECK NUMBER: 206972 CHECK DATE: 3/13/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467099 24309 24977 505.20 WEIGHT STA 44 'BI7157 SALES ORDER Fitness Equipment SALES ORDER NUMBER 0024977 DATE: 2/3/2012 8128 Castleway Court West I SALES PERSON TIM RAGAN Indianapolis, IN 46250 317- 845 -7700 CUSTOMER NUMBER: 01 -CAR01 Fax: 317- 845 -7704 wmv.bobblockf tness.coin SOLD TO: CARMEL FIRE DEPARTMENT SHIP TO: CARMEL FIRE DEPARTMENT 44 2 Civic Square 5032 East Main CARMEL, IN 46032 CARMEL, IN 46033 CONFIRM TO: CUSTOMER P.O.# DELIVERY DATE DELIVERY TIME TELEPHONE PAYMENT TYPE 24309 (317) 571 -2600 QTY ITEM DESCRIPTION PRICE AMOUNT 2 HAMPH90 HAMPTON 90# GRAY HEX DBELL 80.10 160.20 2 HAMPH100 HAMPTN 100# GRAY HEX DBELL 89.00 178.00 1 Med Ball 201-b (The Slammer) 89.00 89.00 Signature: Date: Net Order: 427.20 Expertly Delivered and Installed by Freight: 78.00 Sales Tax: 0.00 Sticker Installed YES NO 505.20 Less Deposit: 0.00 505.20 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)) 24977 $505.20 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 N WARRANT NO. ALLOWED 20 Bob Block Fitness IN SUM OF 8128 Castleway Court West Indianapolis, IN 46250 $505.20 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 24309 I 24977 1 102 670.99 I $505.20 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 MAR 12 2012 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund