215688 12/18/2012 a CITY OF CARMEL, INDIANA VENDOR: 360196 Page 1 of 1
ONE CIVIC SQUARE KIEFER&ASSOCIATES
s' CHECK AMOUNT: $49.45
CARMEL, INDIANA 46032 1700 KIEFER DRIVE
ZION IL 60099 CHECK NUMBER: 215688
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 244071 49 . 45 GENERAL PROGRAM SUPPL
Adolph Kiefer&Associates LLC• 1700 Kiefer Drive• Zion, IL 60099• Phone(800)323-4071 •Fax(847)746-8888
Kiefer INVOICE# DATE DUE DATE PAGE
Invoice 244071 12/04/12 01/03/13 1of1
RECEIVE
D
DEC 0 7 2012
BILL TO BY: SHIP TO
ATTN: ACCOUNTS PAYABLE Carmel Clay Parks & Recreation
Carmel Clay Parks & Recreation 1235 Central Park Drive East
Accounts Payable PO#MC002386
1411 East 116th Street CARMEL, IN 46032
CARMEL, IN 46032
Your P-O.#_.MC003567 - - - Ship-To P.O.;# - -Freight Code Prepaid-&-Add-_ .-
Order Date 12/04/12 Order# 126122.00 Ship Date 12/04/12
Ship Via ID A.PG Terms Net 30 Days Cust ID C549779
• dtj,
:• • � •
Tracking #: 364670250209383
0 620008 EACH $39.95 $39.98 39.95;
-�iIEFER CUSHION FLOAT COLLAR
-rchase
R ascription
�.o.# P C&
G.L.# 7D- ___��?
.udget
i_ine Descr
Purchaser-C Date
proval _ Date
REMIT-TO Subtotal $39.95
1700 Kiefer Drive Freight $9.50
Zion, IL 60099 Tax $0.00
Invoice Amount $49.45
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
12/4/12 244071 Cushion float collar 49.45 $ 49.45
Total $ 49.45
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.
360196 Adolph Kiefer&Associates Allowed 20
1700 Kiefer Dr
Zion, IL 60099-5105
In Sum of$
$ 49.45
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-70 244071 4239039 $ 49.45 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
13-Dec 2012
2
Signature
$ 49.45 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund