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227480 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 264001 Page 1 of 1 c,,tif ONE CIVIC SQUARE RED WING SHOE STORES INC CHECK AMOUNT: $299.73 CARMEL, INDIANA 46032 6653 E 82ND ST ss'+ INDPLS IN 46250 CHECK NUMBER: 227480 CHECK DATE: 12/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4239012 299 . 73 SAFETY SUPPLIES . Red Wing Shoe Store Cast l etbn V i l l age 6653 East 82nd St. Indianapolis, IN 462504577 (317)577-0760 °Y. 12/05/13 14;58 00051044878 Sold By Employee #80200 MISER, WILLIAM (317)571-2289 STORE COPY SALES 00926D 110 6", BROWN, 926 179.99 Major/Nat'l Account 10% -18.00 MA Exempt Govt Agency 0031201550020 SUB-TOTAL 161 .99 7.00% SALES TAX 0.00 TOTAL $161.99 Major Account Charge 161 .99 Sold Items 1 CITY OF CARMEL/COMMU 1 CIVIC SQUARE CARMEL, IN 46032 (317)571-2418 I ACKNOWLEDGE THAT THIS SALE COMPLIES WITH THE CONDITIONS OF THE AGREEMENT MADE WITH T�E MAJOR ACCOUNT X ; MI _ , 'WILLIAM 000051044878 Red Wing Shoe Store Cast ,, Shoe Village 6653 East 82nd St. Indianapolis: IN 462504577 (317)577-0760 11/27/13 10;13 00051044756 Sold By Employee #35559 HOHLT, WILLIAM (317)733-9174 SALES 836030 110 6" BROWN 144.99 Major/Nat'l Account 5% -7.25 MA Exempt Govt Agency . 0031201550020 SUB-TOTAL 137.74 7.00% SALES TAX 0.00 TOTAL $137.74 Major Account Charge 137.74 Sold Items 1 CITY OF CARMEL/COMMU 1 CIVIC SQUARE CARMEL, IN 46032 (317)571-2418 0000510447560 VOUCHER NO. WARRANT NO. ALLOWED 20 Red Wing Shoe Store IN SUM OF $ Castleton Village, 6653 East 82nd Street Indianapolis, IN 46250-4577 $299.73 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1192 42-390.12 $137.74 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1192 42-390.12 $161.99 materials or services itemized thereon for which charge is made were ordered and received except i Friday Dec mb 3, 201 V Director 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)) 11/27/13 Boots- Bill Hohlt $137.74 12/05/13 Boots-Craig Miser $161.99 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