221235 06/18/2013 °ref CITY OF CARMEL, INDIANA VENDOR: 361114 Page 1 of 1
` ONE CIVIC SQUARE SELECTIVE SYSTEMS INC.
CARMEL, INDIANA 46032 4230 S MADISON AVE CHECK AMOUNT: $793.25
INDPLS IN 46227 CHECK NUMBER: 221235
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4237000 29896 793 . 25 REPAIR PARTS
Invoxce
Selective Systems, Inc. MAY 2.8 2013 DATE INVOICE #
4230 S. Madison Ave. $'�=- - _ __ -- 5/16/2013 29896
Indianapolis, III 46227
(317) 783-0077 / FAX: (317) 783-3737
BILL TO SHIP TO
Carmel Clay Parks & Recreation
Attn: Accounts Payable
1235 Central Park Drive East
Carmel, IN 46032
1—P-.0—. NUMBER---— TERMS REP SHIP F.O.B:--- - -PROJEC-T-
Due on receipt 5/16/2013
QUANTITY ITEM CODE DESCRIPTION U/M PRICE EA... AMOUNT
1 MISC 7"monitor 125.00 125.00T
1 MISC Remote programming 225.00 225.00T
1 Technical ... Technical Charges Service call 98.50 98.50
3.5 Technical ... Technical Charges Labor 98.50 344.75
5/17/13 Rec. for ESPN2 was on wrong
channel-reset. Adjust gain on amplifer
to restore pix on TV in lobby. Need to
Re-schedule for MX350 reprogram and
replace defective T' monitor. 5/21/13
Installed new monitor, reprogrammed
remote.
Tax Exempt 0.00 0.00
r•erchase eJMLU" to ,yam/n '
P.O.# 01 (0 Po
G.L.# /M-ai- 42070k,
Bud
LlneeeSCr
Purchaser Date
Approval Date
Total $793.25
Call Vs For HO Flat Panel Displays, Surround Sound Systems, Closed Circuit Cameras and Mobile Satellite
Systems for RV's, Boats, Etc.
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.
361114 Selective Systems, Inc. Terms
4230 S Madison Ave
Indianapolis, IN 46227
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
5/16/13 29896 Repairs to TV and cable 29846 $ 793.25
Total $ 793.25
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.
361114 Selective Systems, Inc. Allowed 20
4230 S Madison Ave
Indianapolis, IN 46227
In Sum of$
$ 793.25
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1096-21 29896 4237000 $ 793.25 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-Jun 2013
Signature
$ 793.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund