244286 04/15/15 J'/ i CITY OF CARMEL, INDIANA VENDOR: 369144
�• ONE CIVIC SQUARE LSO FUNDING GROUP LC CHECK AMOUNT: $*******1 14.00*
f„ �_�: CARMEL, INDIANA 46032 Po Box 404322 CHECK NUMBER: 244286
'�d'rbN�, ATLANTA GA 30384-4322 CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 INV713222815 114.00 GOLF SOFTGOODS
.. ..
Invoice
AM..
F Acct. No. Date Invoice#
20005615 4/2/2015 INV713222815
Klone Lab, LLC. CHECK PAYABLETO
9 Water Street LSQ Funding Group,L.C.
3rd Floor P.O. Box 404322
Amesbury MA 01913
US Atlanta,GA 30384-4322
978-378-3434
Tax I D#27-0771885
Bill To Ship To
City of Carmel<br>Brookshire Golf Course<br>12120 Br... City of Carmel<br>Brookshire Golf Course<br>12120 Br...
Terms Due Date PO# Sales Rep Currency Units
Net 90 7/1/2015 1012142 Tom Richardson US Dollar 19
Shipping Method Ship Date Tracking#
UPS Ground 4/2/2015 1Z86402FO300463765
Style Description Quantity Price Level Unit Price Amount
NBG1000GRY--10 D Minimus LX 1 Base Price 65.00 65.00
NBG1701WK-13 D NBG1701 1 Base Price 55.00 55.00
Subtotal 120.00
Discount(NB Golf Discount-5%) -6.00
Shipping and Handling (UPS Ground) 0.00
Total 114.00
Amount Due $114.00
This account is assigned and payable only to LSQ Funding Group,L.C.
Payments should be sent to them at:
LSQ Funding Group,L.C.
P.O.Box 404322
Atlanta,GA30384-4322
VOUCHER NO. WARRANT NO.
ALLOWED 20
LSQ Funding Group, L.C.
IN SUM OF $
P.O. Box 404322
Atlanta, GA 30384-4322
$114.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I INV713222815 I 43-560.06 I $114.00 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, April 10, 2015
a
Director, Brookshire olf Club
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))
04/02/15 INV713222815 Soft Goods $114.00
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
20Clerk-Treasurer