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225060 10/08/2013 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 4 off�o? INDPLS IN 46250 CHECK NUMBER: 225060 CHECK DATE: 10/8/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 4997 137 . 74 OTHER EXPENSES F' Red W ip Shoe Store Cast eton Village 6653 East 82nd St. Indianapolis, IN 462504577 (317)577-0760 09/04/13 12:39 00051043471 Sold By Employee #35559 DIALLO, AMADOU (317)519=7978 MAJOR ACCOUNT SALES 05611W2100 6" BLACK, WP NON-METAI_L 144.99 Safety Footwear Major/Nat'l Account 5% -7.25 MA Exempt Govt Agency 0031201550020 SUB-TOTAL 137.74 7.00% SALES TAX - - 0.00 TOTAL $137.74 Major Account Charge 137.74 Sold Items 1 CITY OF CARMEL UTILITIES/WATER 3450 W. 131ST ST. CARMEL, IN 46074 (317)733-2855 I ACKNOWLEDGE THAT THIS' SALE COMPLIES WITH THE CONDITIONS OF THE AGREEMENT MADE WITH THE MAJOR ACCOUNT DIALLO,:AMADOU 000051043471, o , � �,. ;,, i ' . , , ', �; � � �, ., �.,� � � � F;. r; � � � � ., �. e i �� 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 (317)577-0760 Invoice Number Invoice Date Terms Description 510000004997 09/16/2013 Net30 ITick-et# Date Purchased By Other Information Item Amount 00051043471 09/04/2013 DIALLO,AMADOU 0561 I W2100 137.74 Total $137.74 Net Total $137.74 Total Merch $137.74 Customer Tax $0.00 Maj.Acet.Tax $0.00 Message: Total Charges $137.74 Customer Payment $0.00 Maj.Acct. Payment $0.00 Total Due $137.74 Date Due 10/16/2013 - - I - - 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 10/1/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/1/2013 4997 $137.74 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 i0/y�3 C� I�Lt ✓��------� Date Officer VOUCHER # 132949 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 4997 01-6200-03 $137.74 Voucher Total $137.74 Cost distribution ledger classification if claim paid under vehicle highway fund