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210585 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 359202 Page 1 of 1 ONE CIVIC SQUARE WATER SAFETY PRODUCTS CARMEL, INDIANA 46032 P 0 BOX 510861 CHECK AMOUNT: $367.00 MELBOURNE BEACH FL 32951 -0861 CHECK NUMBER: 210585 CHECK DATE: 7/5/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1094 4239012 130746 367.00 SAFETY SUPPLIES REMIT PAYMENT TO: Water Safety Products, Inc. INVOICE 130746 ®W 1 128 Tomahawk Dr., INVOICE DATE: 6/8/2012 Indian Harbour Beach, FL 32937 CUSTOMER IN /CARMEL Phone: 1- 800 987 -7238 ORDER 098672 Fax: 321 777 -5438 x# y Page 1 of 1 C EI V E.0...A Bill To: JUN 1 Ship To: CARMEL -CLAY PARKS RECREATION CARMEL -CLAY PARKS RECREATION 1235 CENTRAL PARK DR E BY: DAWN KOEPPER CARMEL, IN 46032 1235 CENTRAL PARK DR E CARMEL, IN 46032 Purchase Order Due Date Shipped VIA Terms 30928 7/8/2012 GROUND: 365292761101681 Net 30 Days aye �o o i 4 Style Color Description Quantity Price Extended Price 237G N/A SPF 30 GALLON 4 $85.00 $340.00 Purchase Description P.O. 3( P or© G.L. Udoet S�CLL Line Descr Purchaser Date Approval Date Total Pieces Subtotal Tax Shipping Total 4 $340.00 $0.00 $27.00 $367.00 _m Visit LIS online at ww.i atewrSaf .ty.c m 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. 359202 Water Safety Products, Inc. Terms 128 Tomahawk Dr. Indian Harbour Beach, FL 32937 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 6/8/12 130746 Sunscreen for staff 30928 367.00 Total 367.00 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. 359202 Water Safety Products, Inc. Allowed 20 128 Tomahawk Dr. Indian Harbour Beach, FL 32937 In Sum of 367.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO #or INVOICE NO. ACCT #/TITL AMOUNT Board Members Dept 1094 130746 4239012 367.00 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 28 -Jun 2012 1P&Z&/72/W Signature 367.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund