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207843 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 365814 Page 1 of 1 ONE CIVIC SQUARE DIVERSIFIED BUSINESS SYSTEMS, INC CHECK AMOUNT: $298.96 CARMEN, INDIANA 46032 8200 HAVERSTICKE ROAD, SUITE 260 INDIANAPOLIS IN 46240 CHECK NUMBER: 207843 CHECK DATE: 4/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4239045 32899 298.96 RETAIL GOODS 8200 Haverstick Road, Suite 260 Indianapolis, Indiana 46240 Phone: (317) 254 -8668 Fax: (317) 254 -0801 e R ©f 3 q2 012, X2899 tip. ti a� BILL TO SHIP TO Carmel Clay Parks Recreatio (9 9 V Carmel Clay Parks Recreation Administrative Offices MAR 2 3 2 012 Monon CQmmttnityLC-enter L SP c:: IE 1411 E. 116th Street 1235 Central Park Drive, East Street Carmel, IN 46032 Carmel, IN 46032 Attn: Paula Schlemmer 'BYs Attn: Attn: Lindsay Labas -o FIE F 30547 Net 20. JC 3f19f2{�12 rU{?S Ground 031 012 o 1 09 10`' isit Pu nch Cards 290 7 Lot 2 0.75 C uantity 200 Nn a 99 Frt�ht 8 21 fat 8.21 PLIrcG135Q t3sct ton ��4 LIn 7escr a urciaser D e "App o 0 j jwlp a I r m.., �n�= T,hank-yau for� busrn�ss TOta I $298.96;- 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. 365814 Diversified Business Systems, Inc. Terms 8200 Haverstick Road, Ste 260 Indianapolis, IN 46240 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3/22/12 32899 MCC Fitness punch pass 30547 298.96 Total 298.96 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 No. Warrant No. 365814 Diversified Business Systems, Inc. Allowed 20 8200 Haverstick Road, Ste 260 Indianapolis, IN 46240 In Sum of 298.96 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members Dept 1092 32899 4239045 298.96 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 5 -Apr 2012 P &hlLrn Signature 298.96 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund