216050 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 359602 Page 1 of 1
ONE CIVIC SQUARE GOLD MEDAL PRODUCTS
CARMEL,INDIANA 46032 3439 N SHADELAND AVE SUITE 2 CHECK AMOUNT: $405.90
o� INDIANAPOLIS IN 46226 CHECK NUMBER: 216050
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4350000 100804 405 . 90 EQUIPMENT REPAIRS & M
•.. .• '• •. . ORIGINAL
OLD MEDAL® PRODUCTS S — IMDIANAPOLIS DIVISION
INVOICE NUMBER 3439 N. SHADELAND AVE. • SUITE 2 • INDIANAPOLIS, IN 46226
100804 E-Mail gmi @gmpopcorn.com www.gmpopcorn.com/indianapolis
NTERED TIMEI I N V OI C
2-20-12 1 Phone 541-9703
PLEASE REMIT TO: AREA CODE 317
DA L' / /� 3439 N. SHADELAND AVE.,SUITE 2
INDIANAPOLIS, IN 46226
SALES CODE
FAX
SOLD TO ! SHIPPED TO (317)541-9730
CARMEL PARKS & REC DEPT CARMEL CLAY PARKS
CARMEL CLAY PARKS ATTN: MICHELLE COMPTON . 14
1411 E 116TH STREET 1235 CENTRAL PARK DRIVE
O SHIP
CARMEL IN 46032 CARMEL, IN 46032 OR T READY
TO SHIP
;USTOMER NUMBER CUST.ORDER DATE CUSTOMER PURCHASE ORDER SHIP VIA TERMS OF SALE
460 0— D
® �® 'DESCRIPTION-- UNIT PRICE
1 0 1 13 EA Atl VF /R°h/c' 178.95 178--95
—_REPAIR LABOR _1F.0-00
'HANK YOU FOR CHOOSING GOLD
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ONCESSION SUPPLY HOUSE. MAKE
WV.GMPOPCORN.COM AND CHECK OUT
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__1AL DEALS UNDER GOLD
MEDAL INDIANAPOLIS. THANKS TO
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RICING! NEW PRICING FOR 50 LB
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"_9 QD5 _3AGS OF GOLD MEDAL PRIVATE LABEL
BAGS!
ERCHANDISE RECEIVED
Purc ase
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Purc haw__ Date
AFP nvaL Date
TO TAIL DUE
PLEASE PAY BY INVOICE
Thanks for this 405.90
STATEMENT SENT ON REQUEST
chance to serve you
ALL CLAIMS FOR DAMAGES IN TRANSIT MUST BE MADE BY CONSIGNEE
NO GOODS MAY BE RETURNED WITHOUT OUR WRITTEN PERMISSION PAY THIS AMOUNT
1'A%MONTHLY SERVICE CHARGE(18%)ADDED TO PAST DUE ACCOUNTS -
INSURANCE ON PARCEL POST SHIPMENTS THROUGH COMMERCIAL CARRIER
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.
359602 Gold Medal Terms
3439 N. Shadeland Ave., Ste 2
Indianapolis, IN 46226
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
12/20/12 100804 Hot dog roller repair 29203 $ 405.90
Total $ 405.90
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.
359602 Gold Medal Allowed 20
3439 N. Shadeland Ave., Ste 2
Indianapolis, IN 46226
In Sum of$
$ 405.90 —J�
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO ACCT#[TITLE AMOUNT Board Members
Dept#
1095-1 100804 4350000 $ 405.90 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
3-Jan 2013
Signature
$ 405.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund