214833 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 353511 Page 1 of 1
i ONE CIVIC SQUARE STOUTS SHOES CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 318 MASSACHUSETTS AVE
� .�a .t�..r. INDIANAPOLIS IN 46204 CHECK NUMBER: 214833
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 3134 150 . 00 MATERIALS & SUPPLIES
STOUTS Invoice
318 MASSACHUSETTS
INDIANAPOLIS, IN 46204-2187 DATE INVOICE#
11/7/2012 3134
BILL TO
CARMEL UTILITIES
3450 WEST 131ST ST
WESTFIELD,IN 46074
P.O. NO. TERMS
CARMEL Net 30
DESCRIPTION QTY RATE AMOUNT
SHOES PURCHASED 9/5/2012 JOHN MASCARI
W03258 SIZE 10 STEEL TOE WOLVERINE 1 150.00 150.00
Total $150.00
>r. View Sales Receipt Page 1 of 1
### REPRINT ### 11/7/2012 10:18:39 AM
Stout's Footwear Est. 1886
13155 N Meridian Street
Carmel, IN 46032
Phone: (317) 848-5432
9/5/2012 11:18 AM 2/22C/48293
3177332855
CARMEL UTILITIES
3450 WEST 131ST ST
WESTFIELD, IN 46074
Regular Sale
STONE 10" STEEL TOE, in INSULATE
W03258 7.5 D 1 189.95
Subtotal: 189.95
Total: 189.95
9 - House Charge 150.00
6 - MC/VISA/DISC 39.95
MasterCard #XXXXXXXXXXXX4665
Approval #678733
Items Sold: 1
Charge Balance: $150.00
Orders (1) , Balance Due $149.75
No Refund after 30 days
No Refund on worn, altered, clearance
Manufacturer defects warranted for 1
year
Like us on Facebook
### REPRINT ### 11/7/2012 10:18:39 AM
https://stouts.enterprise.ricssoftware.com/Core/SalesNiewReceipt.aspx?id=beb6ffc9-c564-... 11/7/2012
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
353511
STOUTS SHOES Purchase Order No.
318 MASSACHUSETTS AVENUE Terms
INDIANAPOLIS, IN 46204 Due Date 11/12/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/12/201', 3134 $150.00
hereby certify that the attached invoice(s), or bill(s) is (are)true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
//�/L Az- a�J' ✓1�� �----
Date Officer
VOUCHER # 122723 WARRANT # ALLOWED
353511 IN SUM OF $
STOUTS SHOES
318 MASSACHUSETTS AVENUE
INDIANAPOLIS, IN 46204
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
3134 01-6200-03 $150.00
Voucher Total $150.00
Cost distribution ledger classification if
claim paid under vehicle highway fund