209862 06/18/2012 CITY OF CARMEL, INDIANA VENDOR: 366302 Page 1 of 1
ONE CIVIC SQUARE WAVE LOCH, LLC
CARMEL, INDIANA 46032 210 WESTBOURNE ST CHECK AMOUNT: $4,165.00
LAJOLLA CA 92037
o CHECK NUMBER: 209862
CHECK DATE: 6/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239039 INVO000181 4,165.00 GENERAL PROGRAM SUPPL
Invoice
:M CE [vED
Number INV0000181
0 2 2912 Date 5/9/2012
Wave Loch, LLC Page 1 �Q(
210 Westbourne Street
La Jolla CA 92037
Phone 858.228.9283 Fax 858.488.1853
Bill To: Ship To:
Carmel Clay Parks Recreation Carmel Clay Parks Recreation
1411 E. 116th Street 1411 E. 116th Street
Carmel IN 46032 Carmel IN 46032
Purchase Order No. Customer ID Salesperson ID Shipping Method Payment Terms I Req Ship Date Master No.
30664 CARM0001 R I 1 15/912012 184
Ordered Shipped B/O Item Number Description Unit Price Ext. Price
5 5 0 S000910 Flowboard, Outlaw 42" $319.00 $1,595.00
2 2 0 S000897 Flowboard, Outlaw 39" $319.00 $638.00
1 1 0 S000914 Flowboard, 39" Carve $145.00 $145.00
2 2 0 S000916 Flwbrd, 39" Carve Chnl $155.00 $310.00
10 10 0 S000001 Bodyboard, Park 38 $119.00 $1,190.00
1 1 0 S000002 Bodyboard, Polypro, Park Pro $129.00 $129.00
Purchase
Description how 1� idev bExmrds
P.O. 3060 Poe
G.L. /09Zf- 42 09039
Budaet
Line'besc d/
Purchaser ate
Approval Date
Subtotal $4,007.00
Misc $0.00
Tax $0.00
Freight $158.00
Please Remit USD Payment To: Total $4,165.00
By Check: Wave Loch, LLC By Wire: Wave Loch, LLC
210 Westbourne Street Bank of America
La Jolla, CA 92037 Acct 0170110023
ABA /Routing #026009593
Swift Code: BOFAUS6S
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.
Wave Loch, LLC Terms
210 Westbourne Street
LaJolla, CA 92037
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/9/12 INV0000181 Flow Rider boards 30664 4,165.00
Total 4,165.00
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.
Wave Loch, LLC Allowed 20
210 Westbourne Street
LaJolla, CA 92037
In Sum of
4,165.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 INV0000181 4239039 4,165.00 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
14 -Jun 2012
PAr1Z&1'nfiY.1U
Signature
4,165.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund