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224634 09/25/2013 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: $137.74 INDPLS IN 46250 CHECK NUMBER: 224634 CHECK DATE: 9/25/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4356003 137 . 74 510000004998 Original Invoice BILL TO- REMIT TO- ATTN. BONNIE CALLAHAN Red Wing Shoe Store CITY OF CARMEL STREET DEPT Castleton Village 3400 W 131ST ST 6653 East 82nd St_ CARMEL,IN 46074 Indianapolis,IN 46250-4577 (317)577-0760 Invoice Number Invoice Date Terms Description 510000004998 09/16/2013 Net 30 —Ticket 9 Date Purchased By Other Information Item - Amount 00051043483 09105/2013 PARKS,PIFER 0561IW2105 137.74 Total $137.74 Net Total $137.73 Total Merch $137.74 Customer Tax $0.00 Maj.Acct. Tax $0.00 Message: Total Charges 5137.74 Customer Payment $0.00 Maj.Acct.Payment $0.00 Total Due $137.74 Date Due 10/16/2013 1 VOUCHER NO. WARRANT NO. ALLOWED 20 Red Wing Shoe Store IN SUM OF $ 6653 E. 82nd Street Indianapolis, IN 46250-4577 $137.74 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 1 510000004998 I 43-560.031 $137.74 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Friday ept er 20 2Q,13 r S$teet Corn I'I>3i �1®1 Title Cost distribution ledger classification if claim paid motor 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 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)) 09/16/13 510000004998 $137.74 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