221680 07/02/2013 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: $387.32
INDPLS IN 46250
CHECK NUMBER: 221680
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 4843 387 . 32 OTHER EXPENSES
Original Invoice
BILL TO- REMIT TO-
ATTN: KERRI LOVEALL Red Wing Shoe Store
CITY OF CARMEL UTILITIES/WATER Castleton Village
3450 W. 131ST ST. 6653 East 82nd St.
CARMEL,IN 46074 Indianapolis,IN 46250-4577
(3 17)577-0760
Invoice Number Invoice Date Terns Description
510000004843 06/16/2013 Net 30
Ticket# Date Purchased By Other Information Item Amount
00051042460 06i10/2013 COOK,STEVE 83608D 120 109 24
Total $109.24
Net Total $109.24
00051042461 06,110/2013 CARPENTER,JEFF 02205D 100 130.49
Total $130.49
Net Total $130.49
00051042489 06/13/2013 COOKSEY,SHAWN 04216D 095 184.49
Customer Tax 2.41
Total $186.90
Customer Payment $36.90
Net Total $150.00
Total Merch $424.22
Customer Tax $2.41
Maj.Acet.Tax 0.00
Message: 'Total Charges $426.63
Customer Payment $36.90
Maj.Acct.Payment $0.00
Total Due $389.73
Date Due 07/16/2013
i
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 CO. Purchase Order No.
6653 E. 82nd St. Terms
Indianapolis, IN 46250 Due Date 6/25/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/25/2013 4843 $389.73
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 fficer
N+°
VOUCHER # 131915 WARRANT # ALLOWED
264001 IN SUM OF $
RED WING SHOE CO.
6653 E. 82nd St.
Indianapolis, IN 46250
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
4843 01-6200-06 /3
Voucher Total $389.73
Cost distribution ledger classification if
claim paid under vehicle highway fund