215006 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 366016 Page 1 of 1
ONE CIVIC SQUARE CJ EDWARDS
CARMEL, INDIANA 46032 579 GRABILL DRIVE CHECK AMOUNT: $385.55
WESTFIELD IN 46074 CHECK NUMBER: 215006
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4350000 1966 385 . 55 EQUIPMENT REPAIRS & M
1
REC
Attn: CJ Edwards 2012 k5
579 Grabill Drive NOV
go } �" voice
(1 ce
Westfield, IN 46074 w 1 r
(317)847-0083 umber: 190
Date: October 27,2012
Bill To: Ship To:
Lindsay Willard i Lindsay Willard
Carmel Clay Parks&Recreation Carmel Clay Parks&Recreation
Monon Community Center Monon Community Center
1235 Central Park Drive East ; 1235 Central Park Drive East
Carmel, IN 46032 Carmel, IN 46032
PO Number Terms
Code
net 30
Date Item# Description Quantity Price Tax 1 Amount
10/19/12 I maintenance(Schwinn IC/Spinners) 30.00 10.00 300,00
Adj handle han 100 500 r
5:00 .;
Toe clip stap 3.00 4.25 E 12:75
10/25/12 Replace chain(Shwinn IC) 0.70 50.00 35.00
Chain(Shwinn IC) 1.00 32.80 I 32.80
1
Purchase GAL ,t _ _ r _- _
Description t.Slt. ��d�.}-W(,
P.O.# 1 PorF �
G.L# 16q�• 21. 3je��p I f
Budgei
Una Descr 3400�
Purcl as Date� ta,. i
Ap p Date
Sub-Total $385.55
State Tax 7.00%on 0.00 0.00
Total —.-->i38S.88
(0350)D,
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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.
366016 Edwards, CJ Terms
579 Grabill Drive
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
10/27/12 1966 Cycle bike maintenance 29143 $ 385.55
4
Total $ 385.55
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.
366016 Edwards, CJ Allowed 20
579 Grabill Drive
Westfield, IN 46074
In Sum of$
$ 385.55
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 1966 4350000 $ 385.55 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
29-Nov 2012
Signature
$ 385.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund