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227367 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 367831 Page 1 of 1 ONE CIVIC SQUARE GROUPDELPHI CHECK AMOUNT: $354.87 CARMEL, INDIANA 46032 8333 CLINTON PARK DRIVE M FORT WAYNE IN 46825 CHECK NUMBER: 227367 CHECK DATE: 12/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4239099 70769R-IN 354 . 87 OTHER MISCELLANOUS Invoice PS, rou INVOICE NUMBER: 70769R-IN gpdelphi INVOICE DATE: 12/13/2013 8333 Clinton Park Drive CUSTOMER PO#: Ft.Wayne, IN 46825 TERMS: Due Upon Receipt SOLD TO: SITE: City of Carmel-Fire Dept Table Throw 2013 2 Civic Square City of Carmel-Fire Dept Carmel, IN 46032 Keith Freer DESCRIPTION JOB NUMBER: 0070769 AMOUNT Purchase-(1)8'Full Black $304.00 X Table Throw with(2)color perma logo Transportation-Freight from $50.87 X Transportation Net Invoice: $354.87 Your Account Executive is Kara Saylor Your Account Manager is Tina Meschberger Freight: 0.00 Sales Tax: 0.00 Invoice Total: $354.87 8333 Clinton Park Dr. Ft.Wayne, IN 46825 P: 260.482.8700 F: 260.482.4877 W:www.groupdelphi.com VOUCHER NO. WARRANT NO. ALLOWED 20 Group Delphi IN SUM OF $ 8333 Clinton Park Drive Ft. Wayne, IN 46825 $354.87 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I 70769R-IN I 42-390.99 I $354.87 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 DEC 19 2013 Fire Chief Title Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 70769R-IN $354.87 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 20 Clerk-Treasurer