175134 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00351414 Page 1 of 1
ONE CIVIC SQUARE SHOE CARNIVAL, INC
CARMEL, INDIANA 46032 PO BOX 2252 CHECK AMOUNT: $626.92
•w;,�_o� i o r INDIANAPOLIS IN 46207 CHECK NUMBER: 175134
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356001 134425 626.92 UNIFORMS
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Shoe Carnival, Inc. INVOICE NUMBER: 134425
7500 EAST COLUMBIA STREET
EVANSVILLE IN 47715 INVOICE DATE: 6/25/2009
Telephone: (812) 867 -6471 Ext. 4815
Telephone: (812) 867 -4572
CARMEL FIRE DEPARTMENT CUSTOMER NO: CARMEL FIRE
QUARTERMASTER CUSTOMER P.O.:
2 CARMEL CIVIC SQUARE
CARMEL IN 46032
CONTACT: TERMS: NET 30
DESCRIPTION AMOUNT
SHOES 626.92
Remit to:
Shoe Carnival. Inc TOTAL SALES 626.92
P.O. Box 225 TOTAL FREIGHT 0.00
Indianapolis, IN 46207 TOTAL TAX 0.00
INVOICE TOTAL 626.92
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EVANSVILLE, IN 47725 INVOICE
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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))
134425 $626.92
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
2fl
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Shoe Carnival
IN SUM OF
P.O. Box 2252
Indianapolis, IN 46207
$626.92
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 134425 43- 560.01 $626.92 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
JUL 2 n 2089
�0 n d
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund