225531 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 00352664 Page 1 of 1
ONE CIVIC SQUARE RELYCO SALES INC CHECK AMOUNT: $1,269.62
CARMEL, INDIANA 46032 121 BROADWAY
DOVER NH 03820 CHECK NUMBER: 225531
CHECK DATE: 10/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4230000 SIN041921 1, 269 . 62 CHECK STOCK
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Hamm
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w4FLYCO 121 Broadway•Dover,NH 03820 INVOICE
T(800)777-7359• (603)742-0999
® F(603)742-9993•E info @relyco.com Invoice Number: SIN041921
www.relyco.com Invoice Date: 10/15/2013
Due Date: 11/14/2013
Purchase Order#: C.Sheeks
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Payment Terms: 1% 10 Net 30
Bill To:5081 Ship To:5081
CITY OF CARMEL CLERK TREASURER CITY OF CARMEL CLERK TREASURER
One Civic Square Cindy Sheeks
Carmel, IN 46032-2584 One Civic Square
USA Carmel, IN 46032-2584
USA
ItemJNumber Description y �� Q�, wUOM QTY�` UOM Ship via Unit Pricer f 1 Ext Price
e ?< `' �e
. - h . fur „Orderetl Shipped ' z sa �€ .s wg
04517 BLUE LASER CHECK BOTTOM 10.00 CS 10.00 CS UPS CWT $114.00 $1,140.00
FREIGHT FREIGHT 1.00 EA 1.00 EA $129.62 $129.62
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We Have A
New Address!
PO BOX 1229 Sub Total $1,269.62
Dover, NH 03821 Shipping& $0.00
Handling
Sales Tax $88.87
Invoice Total $1,358.49
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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
L Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) /
Total
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.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
� IN SUM OF $
�f 0-kd-0
$ 1 )0.�a�
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
07- �j� Z 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
20
Signatu
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund