215748 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 353696 Page 1 of 1
ONE CIVIC SQUARE POWER SYSTEMS INC CHECK AMOUNT: $219.48
�+ CARMEL, INDIANA 46032 PO BOX 51030
KNOXVILLE TN 37950-1030 CHECK NUMBER: 215748
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4238000 1371966 219 .48 SMALL TOOLS & MINOR E
POWER PO Box 51030 INVOICE
KnoxviII e,TN 3)
800,321.6975 TOLL-FREE D. •..
865,769,8223 PHONE
865,769,8211 FAX 1371966 277792 11/30/2012 1 of 1
FIN #: 58-1501009
powersystems.com
Bill To: CARMEL CLAY PARKS and RECREAhlL�fVG�,,.,.;�` �fi;�S ipip To:WILLARD, LINDSAY
ACCOUNTS PAYABLE CARMEL CLAY PARKS&RECREATION
1411 E 116TH ST DEC 0 7 2012 1235 CENTRAL PARK DR E
CARMEL, IN 46032-7611 CARMEL, IN 46032-4421
USA BY: USA
•- C + ' = D D Q • _ --
Ashley Hurt 11/30/2012 Net 30 Days 12/30/2012 29213 2856703
84815 84801-HV Versa-Loop- Heavy- Blue 20 3.95 3.75 75.00
84805 84801-LT Versa-Loop- Light-Green 20 3.45 3.25 65.00
84810 84801-MD Versa-Loop-Medium - Red 20 3.75 3.50 70.00
archase �,,,H`,'n�f
sc;poor,� �u u. r $210.00'
292
Po F ._..
^A/ �� $O.00P
..ine D. ^. _ $219.48;
Dae w _....
=urchaser t
f%pproval _._---------Date e
__ µ $219.44
8
A 1.5% Finance Charge or a $5.00 minimum charge will be applied to all balances over 30 days.
Sales tax is charged based on the ship-to address.
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.
353696 Power Systems Terms
P.O. Box 51030
Knoxville, TN 37950
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
11130/12 1371966 Fitness class equipment 29213 $ 219.48
Total $ 219.48
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.
353696 Power Systems Allowed 20
P.O. Box 51030
Knoxville, TN 37950
In Sum of$
$ 219.48
ON ACCOUNT OF APPROPRIATION FOR
109- Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-21 1371966 4238000 $ 219.48 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
Signature
$ 219.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund