226065 11/18/2013 CITY OF CARMEL, INDIANA VENDOR: 362105 Page 1 of 1
ONE CIVIC SQUARE B S N SPORTS
CARMEL, INDIANA 46032 PO BOX 660176
CHECK AMOUNT: $1,026.00
DALLAS TX 75266-0176 CHECK NUMBER: 226065
CHECK DATE: 11/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239099 95636965 1, 026 . 00 OTHER MISCELLANOUS
Invoice Number Remit to:
BSN Sports Inc
PO Box 660176
"Lilli's H S P OTS- 95636965 Dallas, TX 75266-0176
Date: 10/16/2013
P.O. Box 7726, Dallas, TX 75209 PO Number: 36170
TEL: 800-227-7404 FAX: 972-884-7270 Reference Number: 4970588
Come visit us at www.bsnsports.com Terms: NT30
Due Date: 11/15/2013
Customer #: 1014047
Bill To: CARMEL CLAY PARKS & RECREATION Ship To: Carmel Clay Parks & Recreation
Attn: MARY EVANS Attn: MARY EVANS
1411 E 116TH ST 1235 Central Park Dr. E.
CARMEL IN 46032-3455 CARMEL IN 46032
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NSPHG TRI-FOLD MAT NSPHG 1 EA 750.00 750.00
Thank you for your order. This invoice completes your purchase order.
For realtime order status and tracking information go to www.bsnsports.com
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OCT 212013
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IMPORTANT NOTE ABOUT OUR INVOICES
We know smooth processing of our invoice is important to you. If you have any questions about this invoice, please call your Accounts Receivable Service
Representative (800-227-7404). We will be happy to answer your questions. Please remember to include our invoice number on your payment remittance so
we can properly apply your payment to your account. If you prefer to pay via ACH, we will be happy to give you bank instructions.
Thank you for your business.
To better service your account, please include invoice numbers on your remittance
Invoice # 95636965
Customer #:1014047 Due Date: 11/15/2013
Mercflandise Other ralght Sates Tax............. invo ice Testa[ F'aymOnt C.red. €oral [nvofce
Sub .T4t8E Appie f #knount.:l3ie
$750.00 $0.00 $276.00 $0.00 $1,026.00 1 $0.00 $1,026.00
We accept payments by check, credit card, A H wire and check by phone. Please contact your account rep if you have questions.
If you need a copy of an invoice, please call at 1-800-227-7404 and choose option 2.
*Past due balances are subject to a finance charge of 1.5% per month or the highest rate permitted by applicable law, whichever is lower.
Page 1 of 2
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.
362105 B S N Sports Inc. Terms
P.O. Box 660176
Dallas, TX 75266-0176
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
10/16/13 95636965 Landing mat for Fitness Center 36170 $ 1,026.00
Total $ 1,026.00
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
120_
Clerk-Treasurer
Voucher No. Warrant No.
362105 B S N Sports Inc. Allowed 20
P.O. Box 660176
Dallas, TX 75266-0176
In Sum of$
$ 1,026.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept#
INVOICE NO. CCT#lTITL AMOUNT
1096-21 95636965 4239099 $ 1,026.00 1 hereby certify that the attached invoice(s), or
bills) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
14-Nov 2013
V. AACJ�MVU
Signature
$ 1,026.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund