207927 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 364209 Page 1 of 1
j ONE CIVIC SQUARE JOHNSON HEALTH TECH NA INC
CARMEL, INDIANA 46032 1500 LANDMARK DRIVE
CHECK AMOUNT: $3,890.60
COTTAGE GROVE wl 55527 CHECK NUMBER: 207927
CHECK DATE: 411012012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 9000951207 999.50 EQUIPMENT REPAIRS M
1096 4350000 9000962556 2,891.00 EQUIPMENT REPAIRS M
1 Johnson Health Tech NA Inc. INVOICE
1600 Landmark Drive Document 9000951207
Cottage Grove, WI 53527
0 p H I CI S 00 Phone: 608 839 -1240 Date 03/07/2012
Fax: 608 839 -1260 Page 1 of 1
MAR 1 4 2012 ROMYR
Bill-To: 33001910 Ship -TO: 33004423
CARMEL CLAY PARKS AND REC BY: Clay Park and Rec Carmel
1411 E 116th St Collene Broderick
Carmel, IN 46032 1235 Central Park Dr E
Carmel, IN 46032
Comment:
Shipping Comment: Attn: Lindsay Willard (317) 573 -5249
Purchase Order No. Sales Order No. Sales Person ID Shipping Method Terms Due Date
30504 100532979 GLTM (GreatLakes -TM) UPS GROUND Net 30 04/06/2012
LN# Qty. Model Number Item Number Description List Price Net Unit Price Ext. Price
0010 1 MX15 -DTV ZMD3002555 TV -15' Matrix Mye 1,495.00 897.00_ 897.00
Serial Number(s). MX15DTV11124462
Purcl
pti on
Desc &P y, +I
ipii
P.O. 30 POV
G.L. i 109rO.21• 5
Budc!t Co Ulf ApkU25 4.W11n
Line lescr
Purc aser Date
Appr val Date
Remit To: Discounts 0.00 Freight 102.50
Johnson Health Tech NA Inc. MiscJlDuty 0.00 Frei ht Disc. 0.00
1600 Landmark Drive Other Fees 0.00 Tax 0.00
Cottage Grove, WI 53527 Subtotal 897.00 Total (US6) 999.50
A Service Charge of 1.5% Per Month
Will Apply To All Delinquent Balances
�a Ry ®wy ®Ap VI S I ON� F f 7NES S.
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Johnson Health Tech NA Inc. INVOICE
z00*FN%XS 1600 Landmark Drive Document 9000962556
��II p��
Cottage Grove, WI 53527
NS®r0i Phone: 608- 839 -1240 Date 03/26/2012
Fax: 608 839 -1260 Page 1 of 1
Bill-To: 33001910 Ship-To: 33004423
CARMEL CLAY PARKS AND 1J RE y y Clay Park and Rec Carmel
1411 E 116th St R Ow 97 J� Collene Broderick
Carmel, IN 46032 1235 Central Park Dr E
H
MAR 2 9 2012 Carmel, IN 46032
)BY.
Comment:
Shipping Comment: UPS Ground. Attn: Kurtis (317) 573 -5249
Purchase Order No. Sales Order No. Sales Person ID Shipping Method Terms Due Date
30580 1 100540045 GLTM (GreatLakes -TM) UPS GROUND Net 30 04/25/2012
LN# City. Model Number Item Number Description List Price Net Unit Price Ext. Price
0010 3- ZMD3002555 TV -15" Matrix Mye 1,495.00 897.00 2.691.00
Serial Number(s): MX15DTV12014736
MX15DFV12014750
MXI5DTV12014763
Purc ase `A0kQU I "J I "S (C�1 l,C o
Des: ription_
P.O. 50�� Be F
G.L. 1 C1n(c I— �}�,5CCC0
L esc
Purc aser IWO-
Appi oval Date
I
i
Remit To Discount s 0.00 Freight 200 00
Johnson Health Tech NA Inc. Misc. /Duty 0.00 Freight Disc. I 0.00
1600 Landmark Drive Other Fees 0.00 Tax 0.00
Cottage Grove, WI 53527
Subtotal 2,691.00 Total (USD) .2;891.00
A Service Charge of 1.5% Per Month
Will Apply To All Delinquent Balances w w v
HoRfzom VISION F17NESS. M ^T Fa 9
FITNESS
X S+
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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
364209 Johnson Health Tech NA, Inc. Terms
1600 Landmark Drive
Cottage Grove, WI 53527
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/7/12 9000951207 1 Replacement TV 30504 99950
3/26/12 9000962556 lReplacement TVs for Matrix bikes 30580 2,891.00
Total 3,890.50
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 No. Warrant No.
364209 Johnson Health Tech NA, Inc. Allowed 20
1600 Landmark Drive
Cottage Grove, WI 53527
In Sum of
3,890.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. CCT #/TITL AMOUNT Board Members
Dept
1096 -21 9000951207 4350000 999.50 1 hereby certify that the attached invoice(s), or
1096 -21 9000962556 4350000 2,891.00 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
5 -Apr 20 1 22
6�
Signature
3,890.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund