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209676 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00351248 Page 1 of 1 ONE CIVIC SQUARE JEFF STEWART CHECK AMOUNT: $57.98 4�,?a CARMEL, INDIANA 46032 C/O STREET DEPT C/O STREET DEPT CHECK NUMBER: 209676 CHECK DATE: 6/512012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 57.98 REPAIR PARTS Westfield Yamaha Suzuki Polaris Invoice 18128 Market Ct Ticket Number: 4103983 Westfield, IN 46074 317- 867 -4422 Salesperson: Ray Baisden Cashier: Ray Baisden Sold To: Date: 5/31/2012 CITY OF CARMEL 3400 WEST 131 ST STREET CARMEL, IN 46074 h:317- 733 -2001 Line Item Breakdown Sold S/O Lay P/U Fart Number Src Cat Description Price Sold Now Bin 1 3211077 PO PHP BELT,DRNE (5) $57.98 $57.98 Tax Detail Breakdown Sold Now /Pickup Special Order /Layaway Tax Exempt $0.00 Tax Exempt 0031201550 -020 Total Taxes: $0.00 $0.00 Summary Subtotal $57.98 Invoice Total $57.98 Total Amount Due $57.98 Credit Cards $57.98 Thank you for your Business! 20% Restock Fee On All Returned Items No Refund On Electrical Parts /Accessories No Return on Helmets! All Returns Must Be With 60 Days Of Purchase 4JESTFIELD VAhIAHA SU2 18128 MARKET COURT WESTFIELD. IN 46074 317 867 -4422 TERPIIHAL I.D.; 088600 MERCHAHT 88800019477 05/31/12 10:19 AM SWIPED EXP• >k SALE BATCH: 1078 INU: 000005 AUTH: 031732 TRH REF MCWDFIDHP0531 DESCRIPT IOH- TOTAL $57.98 DUPLICATE# 4RCA[ T PAV ABOVE TOTAL Ah10UIIT 6 TO CARD ISSUER ABREEMEHT ASREDIPIT IF CREDIT VOUCHER) Cti3g;D} B CUB 5/31/2012 10:54:51 AM Page 1 VOUCHER NO. WARRA N ALLOWED 20 Jeff Stewart IN SUM OF c/o Carmel Street Department $57.98 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members 2201 4103983 I 42- 370.001 $57.98 I 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 Friday; June 01, 2012 :r Street Commissi d Title �IOer Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 05/31/12 4103983 $57.98 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