211427 07/31/2012 o•_ \MF
CITY OF CARMEL, INDIANA VENDOR: 353696 Page 1 of 1
ONE CIVIC SQUARE POWER SYSTEMS INC
CARMEL,INDIANA 46032 PO BOX 51030 CHECK AMOUNT: $275.20
KNOXVILLE TN 37950-1030
„o„ a CHECK NUMBER: 211427
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4238000 1321847 275 . 20 SMALL TOOLS & MINOR E
POWER Po Box 51030 INVOICE
KnoxviII e.TN 37950
800,321.6975 TOLL-FREE C I 1321847
865,769,8223 PHONE 7/2/2012
865,769,8211 FAX JUL 0 9 2012 1 of t
FIN #: 58-1501009
. powersystems,com
BY:
Bill To: CARMEL CLAY PARKS and RECREATION Ship To: KOEPPER, DAWN
ACCOUNTS PAYABLE CARMEL CLAY PARKS and RECREATI
1411 E 116TH ST ADMINISTRATIVE OFFICE
CARMEL, IN 46032-7611 1411 E 116TH ST
USA CARMEL, IN 46032-3455
USA
277792 sera 7/2/2012 Net 30 Days 8/1/2012 31028 2808515
e A o a &R=HMMINME .
1 61705 Deluxe Vinyl Coated Dumbbell 5 lb. 40 40 0 EA 5.63 225.20
Purchase
Description P o,f
P.O.# , ,�.
G.L.#�---
Budget �IIrYYI �Q
Line Descr
Date_ —
Purchaser
Date_
Approval
$225.20 $0.00 $50.00 $0.00 $0.00 ® $275.20
COMMENTS
r_ar_imprint—us A 1.5% Finance Charge or a $5.00 minimum charge will be applied to all balances over 30 days.
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.
353696 Power Systems Terms
P.O. Box 51030
Knoxville, TN 37950
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/2/12 1321847 Dumbells for fitness 31028 $ 275.20
Total $ 275.20
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 No. Warrant No.
353696 Power Systems Allowed 20
P.O. Box 51030
Knoxville, TN 37950
In Sum of$
$ 275.20
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 1321847 4238000 $ 275.20 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
26-Jul 2012
Signature
$ 275.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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