213080 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 360196 Page 1 of 1
e ONE CIVIC SQUARE KIEFER&ASSOCIATES
CARMEL, INDIANA 46032 1700 KIEFER DRIVE CHECK AMOUNT: $727.22
ZION IL 60099 CHECK NUMBER: 213080
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239039 220650 727 .22 GENERAL PROGRAM SUPPL
Adolph Kiefer&Associates LLC• 1700 Kiefer Drive• Zion, IL 60099• Phone(800)323-4071 •Fax(847)746-8888
■ INVOICE# DATE DUE DATE PAGE
Kiefer. Invoice ce 220650 09/05/12 10/05/12 1 of 1
BILL TO SHIP TO
ATTN: ACCOUNTS PAYABLE Carmel Clay Parks & Recreation
Carmel Clay Parks & Recreation 1235 Central Park Drive East
Accounts Payable CARMEL, IN 46032
1411 East 116th Street
CARMEL, IN 46032
Your PO# 31221 ' Shi To P.O.,# Frei ht"Code Pre' aid&Add
Order Date 09/05/12 Order# 104898.00 Ship Date 09/05/12
Ship Via ID A.PG Terms Net 30 Days Cust ID C549779
• • • ..
izan
Tracking #: 364670261676952
2 F 2 210403-Red _ _ EAR -j$339:95'i$339 95 $679.90,
- — __— —{ ----' 31 BATTERY PACE CLOCK Red j!_
Purchase
Description
P.O.# 3 as P
G.L.# 109q SEP 10 2012
Bud
Unetw
Purchaser VDate___
Approva_I Date
REMIT-TO Subtotal $679.90
1700 Kiefer Drive Freight $47.32
Zion, IL 60099 Tax $0.00
Invoice Amount $72722
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.
360196 Adolph Kiefer &Associates Terms
1700 Kiefer Dr
Zion, IL 60099-5105
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
9/5/12 220650 Pace Clocks for pools 31221 $ 727.22
Total $ 727.22
I 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. _
360196 Adolph Kiefer&Associates Allowed 20
1700 Kiefer Dr
Zion, IL 60099-5105
In Sum of$
$ 727.22
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
-1094 220650 4239039 $ 727.22 [.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
20-Sep 2012
MIA
Signature
$ 727.22 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund