208459 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 361114 Page 1 of 1
,L ONE CIVIC SQUARE SELECTIVE SYSTEMS INC. CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 4230 S MADISON AVE
INDPLS IN 46227 CHECK NUMBER: 208459
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4237000 28396 150.00 REPAIR PARTS
Invoice
Selective Systems, Inc. y ���IVE� DATE INVOICE
4230 S. Madison Ave. MAR 3 0 2012
3/27/2012 28396
Indianapolis, Ifs 46227 v 'r'
(317) 783-0077 FAX: (317) 783-3737
BILL TO SHIP TO
Carmel Clay Parks Recreation
Attn: Accounts Payable
1235 Central Park Drive East
Carmel, IN 46032
—P--D--NUMBER TERMS REP SHIP F.O.B. PROJECT
AAC002742 Due on receipt 3/27/2012
QUANTITY ITEM CODE DESCRIPTION U/M PRICE EA... AMOUNT
1 MODULATOR Modulator for ch33 fitness center 150.00 150.00T
Tax Exempt 0.00 0.00
p TR(Nw 1.
APR 13 7012
BY:
Purchase
Description t
P.O. P or F
G.L. 10%, Zl-tJ2110
Pudget
Line Desc,Y
Purchaser Date
Approv Date �2 Z
Total $150.00
Call Us For HD Flat Panel Displays, Surround Sound Systems, Closed Circuit Cameras and Mobile Satellite
Systems for RV's, Boats, Etc.
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.
361114 Selective Systems, Inc. Terms
4230 S Madison Ave
Indianapolis, IN 46227
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) PO Amount
3127112 28396 Modulator for Ch33 fitness repair 150.00
Total 150.00
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.
361114 Selective Systems, Inc. Allowed 20
4230 S Madison Ave
Indianapolis, IN 46227
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -21 28396 4237000 150.00 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
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund