208458 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00351087 Page 1 of 1
ONE CIVIC SQUARE SEARS COMMERCIAL ONE
CARMEL, INDIANA 46032 PO BOX 689131 CHECK AMOUNT: $435.20
'c, ion DES MOINES IA 50368 -9131 CHECK NUMBER: 208458
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238000 T846695 435.20 SMALL TOOLS MINOR E
S cars Page 1 of 3
Sequence -1389
Commercial OnW ACCOUNT NUMBER 5405 5340 0749 1408
CUSTOMER SERVICE 1- 800 599 -9712
Account Total Available Billing Cycle Payment Minimum
Balance Credit Line Credit Closing Date Due Date Payment Due
$435.20 $5,000 $4,561 04/05/12 04/30/12 $435.20
Account Summary
Previous Balance $0.00
Payments $0.00
Returns /Exchanges /Adjustments $0.00
Purchases Debits $435.20
Account Balance $435.20
Purchasing Account 5405 5320 0108 0128
Current Purchases and Debits
Detail enclosed for new purc hase items since last statement.
Trans Post Sears Purchase
Date Date Purchase Location Invoice Customer PO Order Amount
04/04 04/04 SEARS HARDWARE 5340 FISHERS IN T846695 SHOP $435.20
20120404005340`900R3953
Total Purchases and Debits for Account Number 5405 5320 0108 0128 $435.20
Total Account Activity for Account Number 5405 5320 0108 0128 $435.20 1
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In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
Your name and account number and sent to the inquiry address on the reverse side.
The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
Your name and account number and sent to the inquiry address on the reverse side.
The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
PLEASE ENTER NEW ADDRESS, TELEPHONE NUMBER OR E -MAIL ADDRESS BELOW:
NAME
ADDRESS
CITY STATE ZIP
HOME PHONE BUSINESS PHONE E -MAIL ADDRESS
srnt;Ra0n00071 1 Rev. 07111
S ea r s SEARS COMMERCIAL ONE Page 3 of 3 CITY OF CARMEL STREET DEPT
CommercialOn PO BOX 630859 ATTN ACCOUNTS PAYABLE
IRVING, TX 75063 -0859 3400 W 131ST ST
CARMEL IN 46074 -8267
Information. 7rai�sactrort 1of 1
Payment Due Date: 04/30/12 Purchase Location: FISHERS Statement Date: 04/05/12
Name: CITY OF CARMEL STREET DEPT Customer PO SHOP
Invoice T846695 Invoice Amount: $435.20 Sears Order
Invoice Date: 04/04/12 Cardholder Name: CITY OF CARMEL STREET DEPT Purchase Card 5405532001
Ship to Address: CARMEL STREET DEPT
CARMEL, IN
Quantity SKU /C?eserlpto
Un1t pace otal Prreo
1 00952368000 TAP SET,CR 14PC STD $34.99 $34.99
2 00911375000 BATTERY, 19.2V REPLACEMENT $29.99 $59.98
1 00966020000 21PC,BLK OXIDE BIT SET $12.49 $12.49
1 00952563000 WRENCH, #4TAP $17.29 $17.29
1 00919959000 GREASE GUN, CONTINUE FLOW $57.49 $57.49
2 00911375000 BATTERY,19.2V REPLACEMENT $29.99 $59.98
1 00946933000 14PC.COMB,WRENCII SET SAE $59.99 $59.99
1 00911548000 19.2V 2DRIL.L,KIT $132.99 $132.99
Payment Address: SEARS COMMERCIAL ONE Total Price: $435.20
PO BOX 689131 Tax: $0.00
DES MOINES IA 50368 -9131 Delivery: $0.00
For Customer Service Call: 1- 800 599 -9712 Grand Total: $435.20
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In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
o Your name and account number and sent to the inquiry address on the reverse side.
o The dollar amount of the suspected error This Account is Issued by Citibank, N.A.
o Describe the error and explain, if you can, why
you believe there is an error. If you need more
information, describe the item you are unsure about.
PLEASE ENTER NEW ADDRESS, TELEPHONE NUMBER OR E -MAIL ADDRESS BELOW:
NAME
ADDRESS
/CITY STATE ZIP
HOME PHONE BUSINESS PHONE E -MAIL ADDRESS
ccnrRr:nnnnrni 1 P— rnr
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))
04/04/12 T846695 $435.20
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 N WARRANT NO.
ALLOWED 20
Sears
IN SUM OF
P. O. Box 689131
Des Moines, IA 50368 -9131
$435.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
r
2201 I T846695 I 42- 380.00 I $435.20 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) hursday April 19, 2012
Street Commissponer
St e iiuivaai
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund