208439 04/25/2012 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: $877.94
INDPLS IN 46250 CHECK NUMBER: 208439
CHECK DATE: 4125/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356003 51000004130 877.94 SAFETY ACCESSORIES
Original Invoice
BILL TO REMIT TO
ATTN: BONNIE CALLAHAN 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
510000004130 04/07/2012 Net30
Ticket Date Purchased By Other Information Item Amount
00051036677 03/27/2012 HUFFMAN, DAVE 06550W2110 80.74
Total $80.74
Net Total $80.74
00051036709 03/30/2012 ALDEN, RICHARD 0221 ID 110 197.99
Total $197.99
Net Total $197.99
00051036752 04/02/2012 HENDERSON, BRAD 05007W2110 99.74
Total $99.74
Net Total I $99.74
00051036753 04/02/2012 CLARK, MICHAEL 06704D 110 121.49
Total $121.49
Net Total $121.49
00051036784 04/06/2012 WILLIAMSON, MIKE 04416E2105 188.99
Total $188.99
Net Total $188.99
00051036785 04/06/2012 MOFFITT, SAMUEL 04433D 110 188.99
Total $188.99
Net Total 1 $188.99
Total Merch $877.94
Customer Tax $0.00
Maj. Acct. Tax $0.00
Message: Total Charges 5877.94
Customer Payment 50.00
Maj. Acct. Payment $0.00
Total Due $877.94
Date Due 05/07/2012
1
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))
04/07/12 510000004130 $877.94
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. W ARRAN T N
ALLOWED 20
Red Wing Shoe Store
IN SUM OF
6653 E. 82nd Street
Indianapolis, IN 46250 -4577
$877.94
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
2201 1 510000004130 I 43- 560.031 $877.94 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
e ThufsdayyApril 19, 2012
Street Commissioner
Street nmm
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund