208298 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 355622 Page 1 of 1
f.. ONE CIVIC SQUARE GOPHER
CARMEL, INDIANA 46032 NW5634 CHECK AMOUNT: $174.27
PO BOX 1450 CHECK NUMBER: 208298
MINNEAPOLIS MN 55485 -5634
CHECK DATE: 4125/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 8463359 174.27 GENERAL PROGRAM SUPPL
Page 1 of 1
I
Invoi
Phone: 1- 800 533 -0446 Fax: 1- 800 451 -4855 Thank you for choosing Gopher ®I
Online: www.gophersport.com Please Remit To:
NW 5634
PO Box 1450
Minneapolis MN 55485
Invoice Number 8463359 t Customer Number: 4050363
Invoice Date. 03- APR -12 Order Date: 02- APR -12
Customer PO number: MC002668A Order Number: 3284647
Payment Method: Net 30 Date Shipped: 02- APR -12
F Billing Address: Carmel Clay Park Recreation Shipping Address: Carmel Clay Park Recreation
1235 Central Park Dr E 1235 Central Park Dr E
Carmel IN 46032 Carmel IN 46032
United States United States
Contact: Koepper Dawn Contact: Koepper, Da
ITEM ITEM: DESCRIPTION QTY: QTY:- QTY UNIT PRICE EXTENDED
i NUMBER r i ORDERED RE D SHIPPED BACK. PRICE
`ORDERED
T
41 -753 Rainbow Nubby Balls 10" dia, Set 1 1 $54.95 $54.95
of 6
17-497 Rainbow Hop -Along Bouncers $109.00
Small (18" dia), Set of 6
$109 00
i
Sub Total: $163.95 1
Tax Total
Shipping, Handling Processing: $27.8 7
Invoice Total: $191.8
Payments Credits: $17.55
Balance Due: $174.27
Purchase ILLS E✓QlL 1�t1L� g�CEI V
Description �r�
P.O. rn e ooa,LrlrA P or F APR 0 4 2012
G.L.# y141_'JgO
Bullet 1� CLI °C`Q�1'Ct1� SIL IPS'
Line Descr
Purchaser Date
Approval Date
Terms: Net Due in 30 days
A late payment charge of 1% per month (18% annum) may be assessed on invoices not paid within terms.
Cu stomer is liable for collection cos re asonable attorney fees and court costs if the account is placed for collection
Unconditional 100% Satisfaction Guarantee
Uncondit o qV,, If you are not satisfied with an Go her® purchase for an reason at an time, contact us and we will replace
5, a100r'Satusfaction. <S Y Y P P Y Y P
the product, credit your account, or refund the purchase price.
No restocking fees. No hassles. No kidding.
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.
355622 Gopher Terms
NW 5634
P.O. Box 1450
Minneapolis, MN 55485 -5634
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/3/12 8463359 Adaptive equipment 174.27
Total 174.27
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.
355622 Gopher Allowed 20
NW 5634
P.O. Box 1450
Minneapolis, MN 55485 -5634 In Sum of
174.27
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -70 8463359 4239039 174.27 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
19 -Apr 2012
7°
Signature
174.27 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund