233492 06/11/14 9♦ur C,Ab
^.! CITY OF CARMEL, INDIANA VENDOR: 359978
b ONE CIVIC SQUARE GOLF COURSE SUPER. ASSOC OF AMERIdECK AMOUNT: $*......415.00'
CARMEL, INDIANA 46032 1421 RESEARCH PARK DR CHECK NUMBER: 233492
9M�ioH Eo r LAWRENCE KS 66049-3859 CHECK DATE: 06/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4355300 164825 415.00 ORGANIZATION & MEMBER
GCSAA01 MEMBERSHIP RENEWAL /®y
cou cows wmwm+own..coa san auxnx
164825 2 5
1421 Research Park Drive • Lawrence,KS 66049-3859 • 785-841-2240 • 800-472-7878 • Fax 785-832-3643
Dues Invoice: 365535
Membership Cycle: 7/1/2014-6/30/2015
PLEASE SIGN FORM&RETURN WITH PMT-OR-RENEW ONLINE @ WWW.GCSAA.ORG Membership Class: A
Class A Renewal Cycle is: 04/06/2011-04/05/2016
Your preferred mailing address:
Robert D.Higgins
PO BOX 960
Westfield,IN 46074-0960
UNITED STATES
NEW Golf Course Information:(Provide ONLY if you have changed courses.)
NEW Home Mailing Address:(Provide ONLY if:i;,�ha;a moved.) Golf Course Name
Street Street
Address Address
City,State,Zip City,State,Zip
Country Country
Phone Phone
Current E-mail Information Publish E-mail address? ❑YES❑NO
bhiggins@c.armel.in.gov
Preferred E-mail address(to be used for all GCSAA correspondence and in the Would you like to continue to receive ❑YES o NO
GCSAA Membership Directory). Go/fCourse Management magazine?
h
If your position/responsibilities have changed and you have not
Your current job title or position is: contacted us,please visit www.gcsaa.org/membership and complete
Golf Course Superintendent a reclassification form.
Tide I here certify th t my information is correct.
Brookshire Golf Course /
Facility/Company/University X
Date
Semi-private 18 1 Member's Signature
Facility Type #Holes Renewal form will be returned to member if not signed."
Please Make A Copy For Tax Purposes:
GCSAA dues are not deductible as a charitable contribution for federal income tax purposes,but may be deductible as an ordinary and necessary business expense.GCSAA estimates that 6%of your
membership dues are not deductible as this portion will be used for advocating position on government issues,as well as for the payment of dues term life insurance for all members excluding students,
affiliate companies,technical assistance network and non-U.S.citizens.
The Environmental institute for Golf is exempt from taxation under Code Section 501(c)(3)of the Internal Revenue Service.Your voluntary gift is deductible as a charitable contribution for federal tax
purposes to the extent provided by law.
•' Make checks payable to:GCSAA
dollars drawn on U.S.bank) ..»_,�-»-,.Yin ...., ......,.... .,...... ,.,-_...,.
❑Check❑Credit Card , " .'
�::�.:;�;�'` ��.. >Membershlp Dues- $365.00
Card Holder Name lease print $0.00)
---- ---- ---- ---- --/20-- l `�TOTALDUESOWEQ, $365.00
Card Number Expiration Date
;'Voluntary;,oltaputikinito;,,bs EnviroiimenW Institute for:Got£ $50.00
Card Holder's Signature -TOTAL DUES and CONTRIBUTION' $415.00
IoLn or renew the Golden Tee CLub by contributing an additional
7112esearch
Questions? Online:www.gcsaa.org k � a • T�.a � $mere^,
Park Dr Contact member solutions at,KS 66D49-3859 SOD-472-7878 Fax:765-832-3643 TOTAL"AMOUNT ENCLOSED: J
6 REN
164825 A Robert D. Higgins 365535 7/1/2014-6/30/2015 $365.00
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))
06/06/14 164825 Dues $415.00
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.
ALLOWED 20
GCSAA
IN SUM OF $
1421 Research Park Drive
Lawrence, KS 66049-3859
$415.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I 164825 I 43-553.00 I $415.00 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
Friday, June 06, 2014
Director, BrookWe Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund