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226810 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 365455 Page 1 of 1 ONE CIVIC SQUARE BRYON SINN CHECK AMOUNT: $144.98 CARMEL, INDIANA 46032 CHECK NUMBER: 226810 CHECK DATE: 12/3/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 90 . 61 OTHER EXPENSES 651 5023990 54 . 37 OTHER EXPENSES a I - DICK ' S SPORTING GOODS j Gal'pw I , IN (317) 818--3467 Westfield Village Park Plaza 11/25/13 07:56 PM [[ Carmel, IN 46033 RECEIPT EXPIRES ON 02/23114 (317) 844-3996 11-25-13 8:33P 0089/0028/0679/3 2350;{XX S-00183 R-1 T-1829 A-0110470-SALE ID# 999-8874-8679-6686-9915-7193-2052 / MN CASUAL SHOE 88457306957$ 34.99 Your assooiate today is�.'S.rzann Item?rice 70.00 YouSave 35.01 f t A!_-E s SUBTOTAL 34,9y T1= 0,00 @ 7,Oi TAX i Customer COPY 0.00 TOTAL $3q,99 CASH . 40.00 CHANGE 5.01- j 018464 52' 411 T1 IEI�Mi)GNAI!6 1Ct9.99 fJ TOTAL SAVED, $35,01 f' ITEM TOTAL 109.99 / � 109.99 THANK YOU FO( SHOPPING AT- KOHL'S SUBTOTAL 109 . 99 --:� i # ITEM IS NOT TAXABLE TOTAL �^ i TAX EXEMPT #PK7X4 110.00 IIIIIIIIIIIIII CASH CHANGE DUE IIIIIIIIIIIIII IIIIIIIIIIIIII IIIIIIIIIIIIII IIIIIIIIIIIIII� III Get rewarded for shopping! Introducing Kohl 's Rewards. N Earn Points on every Purchase. YG Get a $5 Reward for every 100 `I �✓�� See store or KohlsRewards.com forodetails. Terms PURCHASE oIS1SUBJECTPTOy THIS THE TERMS/CONDITIONS FOUND IN LEGAL NOTICES CIfY OF CAPMEL., •L AT KOHLS.COM, Q17) 23.2-2339 5 Illlllllli � Illlllll�illl IIIIIIIIIIIIIIII 1001830011829112513014 Get Your ScoreCard_t oJayi.. .. It's FREE! Score one-potrtt, for every mercl jai�ci t st: pin-chased 300-points :=,$10 .Reav. - Visit Myl?icksSpor:tit,i9Goodn._r;Qm or ,More i of ormat i on; ; VOUCHER # 133467 WARRANT # ALLOWED T9940 IN SUM OF $ SINN, BRYAN Carmel Utilities Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 120213 01-6200-07 $90.61 Q Voucher Total $90.61 Cost distribution ledger classification if claim paid under vehicle highway fund 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 T9940 SINN, BRYAN Purchase Order No. Carmel Utilities Terms Due Date 11/26/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/26/201: 120213 $90.61 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 Date Officer Westfield Village Park Plaza Carmel, -IN 46033 (317) 844-3996 11-25-13 8:33P - 0084/0028/0679/3 23SOXXX ID# 999-8874-8679-6686-9915-7193-2052 MN CASUAL SHOE 884573069578 + 34.99 1t Item?rice 70.00 YouSave 35.01 SUBTOTAL 34.99 T1= 0.00 @ 7.0% TAX 0.00 TOTAL CASH 40.00 CHANGE 5.01- / TOTALAVED. $35,O1 THANK YOU FO ING AT OHL'S 4 ITEM IS NOT TAXABLE (III I I IIIIIIIII III IIII I I I I III II IIII IIIIIIIIIIIIIIIII Get rewarded for shopping! Introducing Kohl's Rewards. Earn Points on every Purchase. Get .a $5 Reward for every 100 Points. See store or KohlsRewards.com for details. Terms and conditions apply.. THIS PURCHASE IS SUBJECT TO'THE TERMS/CONDITIONS FOUND IN LEGAL NOTICES AT KOHLS.COM. HASSLE-FREE RE?URNS RETURN ANY ITEM,ANYTIME, FOR ANY REASON. DO YOU HAVE YOUR RECEIPT? You'll get a full refund or even exchange. If you have a gift receipt,you'll get an even exchange or a.Merchandise Credit. NO RECEIPT? NO PROBLEM! If ybu paid with a Kohl's Charge or any other major credit card,we can look up your purch9se and give you a full refund or everi exchange. Otherwise,.you'll get an even exchange or a Merchandise Credit. DID YOU PAY WITH A•CHECK OR DEBIT CARD? You'll get cash,a Merchandise Credit or a corporate refund. We may ask for a valid form of.ID. When paying by check,you authorize us.to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a.chec*transaction. For inquiries,please call 1-800-564-5740. WE-DO PRICE ADJUSTMENTS! If something you purchased goes on sal6, bring it back with the receipt within 14 days and we'll give it to you for the sale price. HASSLE-FREE RETURNS RETURN ANY ITEM,ANYTIME,'FOR ANY REASON. DO YOU HAVE YOUR RECEIPT? You'll get a full refund or even exchange. If you have a gift receipt,you'll get an even exchange or a Merchandise Credit. �� Mo RGr`M1DT7 I\I('1 DMnrll GAAI DICK ' S SPORTING GOODS Carnwl . IN (317) 818-3467 11/25/13 07:56 PM RECEIPT EXPIRES ON 02/23/14 S-00183 R-1 T-1829 A-0110470,SALE Your associate today i s. S rzann- fRX F-- Customer Customer Copy ' 018464525427 TIfERMOGWikI/!i 109.99 N ITEM TOTAL 109.99 SUBTOTAL 109.99 TOTAL 109 . 99 TAX EXEMPT #PK7X4 CASH 110.00 CHANGE DUE 0.01 �i�YG ti Od) CITY OF CARMEL (317) 232-2339 �J IIII VIIIIIIIIIIIIIIIIIII.IIIIIIIIIII 1001830011829112513014 Get your ScoreCard today! It's FREE! Score one point. for every $'I (if merchandise purchased." 300 points =.$1.0 Reward Visit MyDicksSpor:tirrgGoods.com for more information. .K'.A'A:X K'K* Don't miss our• Black Fridav Deals! Doors open at 8pm Thanksgiving evening! Dozens of In-Store Deals Friday, Saturday and Sunday! Check your local paper for our weekly and Thanksgiving Day circulars. It ir'K yc A'CM;C'A'A''KK K'K iCW YC A'�A'K Y(A'A'AY(;CA YC� Give Thanks. And help the children at St. Jude Children's Research,,Hospital r Three Ways to Donate: 1) Text KIDS to 50333 to donate $5.* 2> Donate in-store 3) Donate online www.DickSportingGoods.com/StJude * Msg & data rate may apply. See website for details. �KYlY(7C:CYC:tYC7KYCYtYt It;r Yl JY'K Y(A"K'K A'7Y 7C:C Yf��:C Share your.passion for sports this holiday season! Now Hiring Part-time Seasonal Associatesl Apply on ine Frt: www..Di cksSpor-t-i-rifjgoods.•i obs/!-your 1 y Get $10 off your next purclOse of $ Complete our online Customer Survey at www.DioksSportinyGoods.com/feedback. Survey must be comid e-ted within 7 days of store visit. DISPONIBLE EN ESPANOL W*X 9AA:*W AA' Shop us online or mobile at DicksSportingGoods.com Like us on Facebook! DicksSportingGoods Follow us on lwitter! @DICK` RP represents the return price for an item based on all discounts 'that have been applied_ accept) tnat win De recorcieti at the time of the return. Information from your ID will be retained in a company-wide database of customer return activity that Dick's Sporting Goods and its affiliates use to authorize returns. Dick's Sporting Goods reserves the right to limit returns or exchanges regardless of receipt. • All returns and exchanges must be new, in the original packaging and contain all the parts and accessories. • Returns with an original sales receipt will receive a refund based on the initial form of payment. • Returns or exchanges without a receipt will be offered a store credit for the lowest price or offered the manufacturers'contact information. • Returns with a gift receipt will be offered a gift card or exchange. • Returns where a ScoreCard reward certificate was redeemed, may result in an adjusted refund amount. • Firearms and Ammunition cannot be returned. • Baseball bats, Gas and Electric Scooters cannot be returned if the package is opened or the factory seal is broken. • Dick's accepts the following IDs for returns: US or Canadian Driver's License, U.S. State ID, US Military ID, or Passport. An original sales receipt dated within 90 days is required for all returns&exchanges. To return or exchange an item without an original sales receipt, you will be required to present a valid photo ID (see below for the types of ID that we accept) that will be recorded at the time of the return. Information from your ID will be retained in a company-wide database of customer return activity that Dick's Sporting Goods and its affiliates Use to.authorize returns. Dick's Sporting Goods reserves the right to limit returns or exchanges regardless of receipt. • All returns and exchanges must be new, in the original packaging and contain all the parts and accessories. • Returns with an original sales receipt will receive a refund based on the initial form of payment. • Returns or exchanges without a receipt will be offered a store credit for the lowest price or offered the manufacturers'contact information. • Returns with a gift receipt will be offered a gift card or exchange. • Returns where a ScoreCard reward certificate was redeemed, may result in an adjusted refund amount. • Firearms and Ammunition cannot be returned. • Baseball bats, Gas and Electric Scooters cannot be returned if the package is opened or the factory seal is broken. • Dick's accepts the following IDs for returns: US or Canadian Driver's License, U.S. State ID, US Military ID, or Passport. An original sales receipt dated within 90 days is required for all returns&exchanges. To return or exchange an item without an original sales receipt, you will be required to present a valid photo ID (see below for the types of ID that we accept) that will be recorded at the time of the return. Information from your ID will be retained in a company-wide database of customer return activity that Dick's Sporting Goods and its affiliates use to authorize returns. Dick's Sporting Goods reserves the right to limit returns or exchanges regardless of receipt. • All returns and exchanges must be new, in the original packaging and contain all the parts and accessories. • Returns with an original sales receipt will receive a refund based on the initial form of payment.. • Returns or exchanges without a receipt will be offered a store credit for the lowest price or offered the manufacturers'contact information. • Returns with a gift receipt will be offered a gift card or exchange. • Returns where a ScoreCard reward certificate was redeemed, may result in an adjusted refund amount. • Firearms and Ammunition cannot be returned. Baseball bats, Gas and Electric Scooters cannot be returned if the package is opened or the factory seal is broken. • Dick's accepts the following IDs for returns: US or Canadian Driver's License, U.S. State ID, US Military ID, or Passport. An original sales receipt oated within 90 days is required for all returns&exchanges. To return or exchange an item without an original sales receipt, you will be required to present a valid photo ID (see below for the types of ID that we accept) that will be recorded at the time of the return. Information from your ID will be retained in a company-wide database of customer return activity that Dick's Sporting Goods and its affiliates use to authorize returns. Dick's Sporting Goods --r—c tho rinht to limit rnturnc nr VOUCHER # 136930 WARRANT # ALLOWED T9949 IN SUM OF $ SINN, Bryon carmel utilities Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 120213 01-7200-07 $54.37 � Il Voucher Total $54.37 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee T9949 . SINN, Bryon Purchase Order No. carmel utilities Terms Due Date 11/26/2013 Invoice Invoice Description Date Number (or note attached inyoice(s) or bill(s)) Amount 11/26/201: 120213 $54.37 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 Date Officer