HomeMy WebLinkAbout212103 08/28/2012 „yf CITY OF CARMEL, INDIANA VENDOR: 366496 Page 1 of 1
ONE CIVIC SQUARE 123 WELLNESS
,` to CARMEL, INDIANA 46032 618 ST.JOSEPH LANE CHECK AMOUNT: $248.75
PARK HILLS KY 41011 CHECK NUMBER: 212103
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4238000 3465 248 . 75 SMALL TOOLS & MINOR E
TZT717`'FIVED Invoice
° °. . AUG 0 9 2012
Date Invoice#
618 St Joseph Lane 8/9/2012 3465
Park Hills, KY 41011
Bill To Ship To
Carmel Clay Parks&Rec Carmel Clay Parks&Rec
Administrative Offices c/o Lindsay Willard
c/o Dawn Koepper 1235 Central Park E
1411 E. 116th Street Carmel, IN 46032
Carmel,IN 46032
PO ^Ju, .bcr Terms Rep Ship Via F.O.B. Project
MC003169 Due on receipt JT 8/9/2012
QTY Item Code Description List Price Your Price Each Amount
10 SM- l OGS Y x 4'Heavy Duty PVS Bike Mat 16.875 168.75
1 Freight Freight 80.00 80.00
Purchase (3t"Oter_-I lVe - (W r 1'Y)QJS
Description fUl' C'.t ICl 5
P.O.#LYl C O U 31 C�yq —Port
G.L.#
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Line Descr_ \Y-1�1I141�C
Purchaser CL•w I layd Date
Approval Date
Total $248.75
Our Phone# Our Fax# E-mail Web Site
(513)616-7063 (859)491-2696 joe(i__4123wellnessinc.com ww�v.123wellnessinc.com
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.
123 Wellness Inc. Terms
618 St. Joseph Lane
Park Hills, KY 41011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/9/12 3465 Protective floor mats for c Ice bikes $ 248.75
Total $ 248.75
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.
123 Wellness Inc. Allowed 20
618 St. Joseph Lane
Park Hills, KY 41011
In Sum of$
$ 248.75
i
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 3465 4238000 $ 248.75 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
23-Aug 2012
PAhArnoy-IL
Signature
$ 248.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund