226086 11/18/2013 CITY OF CARMEL, INDIANA VENDOR: 361104 Page 1 of 1
0 ` ONE CIVIC SQUARE CYBEX INTERNATIONAL INC
CHECK AMOUNT: $21.55
CARMEL, INDIANA 46032 Po Box 8500-1401
PHILADELPHIA PA 19178-1401 CHECK NUMBER: 226086
CHECK DATE: 11/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4237000 927871 21 . 55 REPAIR PARTS
Global Headquarters Remit to:
_<Y_CYBEX'
10 Trotter Drive Cybex International, Inc. INVOICE
Medway, MA 02053 P.O. Box 8500-1401
Cybex International, Inc. (508)533-4300 Philadelphia, PA 19178-1401
(508)533-5500 fax United States Page 1 of 1
Sold To: Carmel Ciay Parks&Recreation Ship To: Carmel Clay Parks&Recreation
1411 E. 116th St. 1235 Central Park Dr. E. Invoice Information
Carmel IN 46032 Monon center Invoice Date: Oct/31/2013
USA Carmel IN 46032 Invoice: 0000927871
USA Customer No: CYB0037634
Payment Terms: Net 30
Bill To:
Carmel Clay Parks&Recreation _ Due Date: Nov/30/2013
Carrie Keaveney RECE W AMOUNT DUE: 21.55 USD
1411 E. 116th St.
Carmel IN 46032 NOV 0 4 2013
United States
Shipment Information
Date Shipped: Oct/31/2013
Sales Order No: SVC0647936
Purchase Order No: MC004758
Pro No: 1Z5638020353585052
Carrier. United Parcel Service, Inc.
- - Ship Via: *UPS GRND -
Freight Terms: Prepaid
Line Product No. Description Quantity uOM Unit Amt Tax Net Amount
1 PR069400 Recess Bumper 5.00 EA 1.73 N 8.65
2 HC622815 KT 1/4-20x3/4 SCK HD CAP SCR 5.00 EA 0.53 N 2.65
3 OWTPRTFRT Shipping and Handling Charge 1.00 EA 10.25 N 10.25
Subtotal: 21.55
Subtotal (Sales/Use): 0.00
AMOUNT DUE: 21.55USD
Order Entered by Chris Yanovitch.
Buyer accepts and agrees to prices, specifications, standard terms& conditions of sale, including
warrantv terms on this document. toeether with all the attachments hereto.
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.
361104 Cybex International, Inc. Terms
P.O. Box 8500-1401
Philiadelphia, PA 19178-1401
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
10/31/13 927871 Repair parts $ 21.55
Total $ 21.55
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.
361104 Cybex International, Inc. Allowed 20
P.O. Box 8500-1401
Philiadelphia, PA 19178-1401
In Sum of$
$ 21.55
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO kCCT#/TITLI AMOUNT Board Members
Dept#
1096-21 927871 4237000 $ 21.55 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
14-Nov 2013
Signature
$ 21.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund