218209 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1
ONE CIVIC SQUARE RED WING SHOE STORES INC
CARMEL, INDIANA 46032 6653 E 82ND ST CHECK AMOUNT: $555.72
d� INDPLS IN 46250
CHECK NUMBER: 218209
CHECK DATE: 3/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4602 555 . 72 OTHER EXPENSES
Original Invoice
BILL TO- REMIT TO-
ATTN: KERRI LOVI?ALL Red Wing Shoe Store
CITY OF CARMFL UTILITIES/WATER Castleton Village
3450W. 131ST ST. 66531ast 82nd St.
CARMEL,IN 46074 Indianapolis,IN 462504577
(3 t7) 577-0760
Invoice Number Invoice Date Terms Description
10(10(10(146(12 (12/09/2013 Net 3(1
Ticker# Date Pu'cl]asedBv Otherinforluation Item Amount
00051040237 01;04/2013 LUPER,MICHAEL 04216D 130 184.49
Customer Tax 2.4
Total $186.90
Customer Pavment $36.90
Net Total $150.()0
00051040238 01;04/2013 FORRFR,JACK 02260D 105 17099
Customer Tax 147
Total 517146
Customer Pavment $22.46
Net Total $150.00
00051040242 Ot?(14/2(11 3 RICK1?L.M1\TT 0224617,2095 179.99
Customer Tax 2.10
Total $182.09
Customer Pa),ment $32.09
Net Total $150.00
000510403,28 OI i l 1 x2013 EIDSON,LARRY 02226E2150 161.99
Customer Tax 0.84
Total $162.83
Customer Pavment $12.83
Net Total S150.0()
00051040329 0 V1 1.12013 R1..'CK.MICAH 05526M 100 132.99
Total $132.99.
Net Total $132.99
(100510=10330 0111 12013 MERRILL,GARY 83624D 095 137.74
Total $137.74
Net Total $137.74
00051040.131 01,11/2013 I,PP,ciRE,G 066701)085 134.99
Total $134.99
Net Totat $134.99
Total Mcrch $1,103.18
Customer Tax $6.82
Maj.Acct.Tax $0.00
Messa;,e: Total Charges $l,l 10.00
Customer Payment $1(14.28
Maj.Acct. Payment $0.00
Total Due $1,005.72
Date Due 03/11/2013
1
VOUCHER # 126733 WARRANT # s ALLOWED
264001
IN SUM OF $
RED WING SHOE STORES INC
6653 E. 82ND STREET
INDIANAPOLIS, IN 46250
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
i
Board members
i
PO# INV# ACCT# AMOUNT Audit Trail Code
51000000460 01-7200-02 $555.72
'i
I
i
i
Voucher Total $555.72
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
264001
RED WING SHOE STORES INC Purchase Order No.
6653 E. 82ND STREET Terms
INDIANAPOLIS, IN 46250 Due Date 2/21/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/21/2013 5100000046( $555.72
I 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 Date Officer