220963 06/18/2013 a *f CITY OF CARMEL, INDIANA VENDOR: 026625 Page 1 of 1
ONE CIVIC SQUARE BOB BLOCK FITNESS EQUIP
CARMEL, INDIANA 46032 8128 CASTLEWAY COURT WEST CHECK AMOUNT: $105.00
INDIANAPOLIS IN 46250 CHECK NUMBER: 220963
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 84167 105 . 00 OTHER CONT SERVICES
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INVOICE
Fitne.�..� Equinm�nt INVOICE NUMBER 0084167-IN
INVOICE DATE 06/07/2013
8128 Castleivay Court West SALESPERSON TIM RAGAN
Indianapolis, IN 46250 CUSTOMER NUMBER O 1-CARO 1
(317)845-7700
Fax: (317)845-7704
www.bobbl ockfitness.com
SOLD TO: CARMEL FIRE DEPARTMENT SHIP TO: CARMEL FIRE DEPARTMENT 45
2 Civic Square 10701 N College Ave
CARMEL, IN 46032 INDIANAPOLIS, IN 46280
CONFIRM TO:
P.0.-N1 2MBER PAID-B-Y-:_- _ -CHECK#--- -—REFERENCE- ------ TERMS — -
DUE ON RECEIPT
ITEM DESCRIPTION ORDERED SHIPPED B/O UNIT PRICE TOTAL
TRUE PEDCS60- S/N: 09-6T01 126B
NEEDS MAIN KEYPAD OVERLAY. 2 BENCH PADS NEED
RE-UPHOLSTERED.
/LABOR SERVICE LABOR 80.00
/TRIP SERVICE TRIP CHARGE 25.00
THANK YOU FOR THE OPPORTUNITY TO BE OF SERVICE Net invoice: 105.00
Freight: 0.00
Sales Tar: 0.00
105.00
Less Deposit: 0.00
105.00
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
84167 Repair Treadmill-45s $105.00
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.
ALLOWED 20
Bob Block Fitness
IN SUM OF $
8128 Castleway Court West
Indianapolis, IN 46250
$105.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
1120 I 84167 I 43-509.00 I $105.00 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
>li twi 11 � �1Z
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund