212369 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 00351414 Page 1 of 1
ONE CIVIC SQUARE SHOE CARNIVAL, INC
CARMEL, INDIANA 46032 CHECK AMOUNT: $715.00
Po sox zzsz
INDIANAPOLIS IN 46207 CHECK NUMBER: 212369
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356001 1691839 715 . 00 UNIFORMS
SHOE N IV Ae L
*****INVOICE*****
Shoe Carnival, Inc. INVOICE NUMBER: 1691839
7500 EAST COLUMBIA STREET
EVANSVILLE IN 47715 INVOICE DATE: 6/26/2012
(812) 867-6471 Ext . 4815
CARMEL FIRE DEPARTMENT CUSTOMER NO: CARMEL FIRE
QUARTERMASTER CUSTOMER P.O. :
2 CARMEL CIVIC SQUARE
CARMEL IN 46032
CUSTOMER DOC RETENTION: CATEGORY 2
CONTACT: TERMS : NET 30
DESCRIPTION AMOUNT
SHOES FOR GARY CARTER 715 . 00
Remit to:
Shoe Carnival. Inc. TOTAL SALES 715. 00
P.O. BOX 2252 TOTAL FREIGHT 0. 00
Indianapolis, IN 46207 TOTAL TAX 0 . 00
INVOICE TOTAL 715 . 00
Irescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
kn invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
vhom, 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))
1691839 $715.00
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.
ALLOWED 20
Shoe Carnival
IN SUM OF $
P.O. Box 2252
Indianapolis, IN 46207
$715.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 1691839 I 43-560.01 I $715.00 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
AUG 2 .72012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund