218914 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 360196 Page 1 of 1
= ONE CIVIC SQUARE KIEFER&ASSOCIATES CHECK AMOUNT: $49.45
a CARMEL, INDIANA 46032 1700 KIEFER DRIVE
ZION IL 60099 CHECK NUMBER: 218914
CHECK DATE: 4/912013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 267924 49. 45 GENERAL PROGRAM SUPPL
Adolph Kiefer&Associates LLC• 1700 Kiefer Drive• Zion, IL 60099• Phone(800)323-4071 •Fax(847)746-8888
v ■ INVOICE# DATE DUE DATE PAGE
Kiefel. I■n■ ° ®I �+Q 267924 03/20/13 04/19/13 1 of 1
BILL TO MAR 2 5 W3 SHIP TO
ATTN: ACCOUNTS PAYABLE ATTN: Brooke
Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation
Accounts Payable ,.a 1235 Central Park Drive East
1411 East 116th Street Carmel, IN 46032
Carmel, IN 46032
Your_PO_#. MC003934 _- Ship-To P.O.#' SM _ �_, Freight Code_ Prepaid&Add._R
Order Date 03/20/13 Order# 147736.00 Ship Date 03/20/13
Ship Via ID C.PO Terms Net 30 Days Cust ID C549779
bisc
Tracking #: 9405510200883721231016
L�J 620008 TEACH $39.95' � —$ s9 5
—� KIEFER CUSHION FLOAT COLLAR
P.G.# P or F
c.L#
i_.ire�Descr
purchaser_ —�
—D •te
REMIT-TO Subtotal $39.95
1700 Kiefer Drive Freight $9.50
Zion,IL 60099 Tax $0.00
Invoice Amount $49.45
6 ... p
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
3/20/13 267924 Adaptive swim lesson supplies $ 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 Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT
1096-70 267924 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
4-Apr 2013
`f Q,hj
Signature
$ 49.45 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund