207591 03/26/2012 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
ONE CIVIC SQUARE RED WING SHOE STORES INC
CARMEL INDIANA 46032 6653 E 82ND ST CHECK AMOUNT: $260.23
INDPLSIN 46250
CHECK NUMBER: 207591
CHECK DATE: 3/26/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356003 260.23 510000004090
Original Invoice
BILL TO REMIT TO
ATTN: BONNIE CALL.AHAN Red Wing Shoe Store
CARMEL CITY STREET DEPT Castleton Village
3400 W 131ST ST 6653 East 82nd St.
CARMEL, IN 46074 Indianapolis, IN 46250 -4577
(317) 577 -0760
Invoice Number Invoice Date Terms Description
510000004090 03/17/2012 Net 30
Ticket Date Purchased By Other Information Item Amount
00051036313 02/28/2012 KILLEN, TERRY 06337H 095 103.49
Total $103.49
Net Total $103.49
00051036429 03/08/2012 BENTLEY, JAMES 83400D 100 156.74 x
Total $156.74
Net Total $156.74
Total Merch $260.23
Customer Tax $0.00x.
Maj. Acct. Tax $0.00
Message: Total Charges $260.23
Customer Payment $0.00
Maj. Acct. Payment $0.00
Total Due $260.23''
Date Due 04/16/2012
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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))
03/17/12 510000004090 $260.23
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 N WAR NO.
ALLOWED 20
Red Wing Shoe Store
IN SUM OF
6653 E. 82nd Street
Indianapolis, IN 46250 -4577
$260.23
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 1 510000004090 1 43- 560.031 $260.23 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
/1 Thursday iMa' 22, 2012
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Street Commissiog r
StfCCl L:.}(11tIIIJJIU
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund