248274 08/12/15 1J°��5N;11F,
CITY OF CARMEL, INDIANA VENDOR: 197000
ONE CIVIC SQUARE CINTAS CORPORATION#018 CHECK AMOUNT: $*******184.45*
?� CARMEL, INDIANA 46032 PO BOX 630803 CHECK NUMBER: 248274
9.�yiTON�` CINCINNATI OH 45263-0803 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239012 5003361296 184.45 SAFETY SUPPLIES
•
MP
0 On 10r&. FAS Svc/Billing Questions: 317-264-5103
____ ____ __ _ FAX: 317-264-5119
Indianapolis, IN 46239 Payment Inquiry: 888-994-2468
ROUTE # Loc #0388 Route 0005
INVOICE
PLEASE PAY DIRECTLY FROM THIS INVOICE
BROOKSHIRE GOLF CLUB INVOICE # 5003361296
12120 BROOKSHIRE PKWY DATE 7/28/15
CARMEL, IN 46033-3314 PO # N/A
317-846-7431 CUSTOMER # 0010069450
PAYER # 0010087731
SVC ORDER # 8010803538
CREDIT TERMS NET 10 DAYS
- UNIT _EXT
MATERIAL # DESCRIPTION QTY PRICE PRICE TAX
466844 PRO SHOP 00594670
110 CABINET CLEANED 1 $0.00 $0 .00
120 CABINET ORGANIZED 1 $0 .00 $0 .00
130 EXPIRATION DATES CHECKED 1 $0 .00 $0 .00
132 BBP KIT CHECKED 1 $0.00 $0 .00
400 SERVICE CHARGE 1 $9.95 $9 .95
31069 1X3 PLASTIC BANDAGE MED 1 $9.42 $9 .42
44269 ELASTIC STRIP MEDIUM 1 $9.78 $9 .78
55556 DISINFECTANT WIPE 1 $5.95 $5 .95
62029 XPECT BURN CARE PUMP 2 OZ 1 $9 .76 $9 .76
100039 TRIPLE ANTIBIOTIC OINT SM 1 $8.86 $8.86
100439 HYDROCORTISONE CREAM SM 1 $7 .63 $7.63
111529 PAIN AWAY X-STRENGTH SM 1 $10 .88 $10 .88
111989 IBUPROFEN TABS MEDIUM 1 $18.85 $18.85
130479 EYEWASH, 1/2OZ MEDIUM 1 $16.21 $16.21
280020 LENS/SCREEN PADS 100/BX 1 $20.70 $20.70
UNIT SUBTOTAL $127.99
46684.5 MAINT 00594663
110 CABINET~CLEANED 1 $0.00 $0 .00
120 CABINET ORGANIZED 1 $0 .00 '$0 .00
130 EXPIRATION DATES CHECKED 1 $0 .00 $0 .00
55556 DISINFECTANT WIPE 1 $5 .95 $5 .95
111329 ACETAMINOPHEN SM 1 $9 .98 $9 .98
111929 IBUPROFEN TABS SMALL 1 $11 .63 $11.63
119260 ALLERGY RELIEF TABLET MED 1 $19 .59 $19.59
587819 PEPTO BISMOL 12CT 1 $9 .31 $9.31
UNIT SUBTOTAL $56 .46
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1199 - Indianapolis`FAS Svc/Billing Questions: 317-264-5103
1435 Brookville Way FAX: 317-264-5119
Indianapolis, IN 46239 Payment Inquiry: 888-994-2468
ROUTE # Loc #0388 Route 0005
REMIT TO CINTAS CORPORATION SUB-TOTAL $184 .45
PO BOX 631025 TAX $0 .00
CI I, OH 63-1025 TOTAL $184 .45
C J
SIGNATURE: - - -- - -- --------- DATE: ----
NAME: ------------------------------
VOUCHER NO. WARRANT NO.
ALLOWED 20
Cintas Corporation
IN SUM OF $
P.O. Box 631025
Cincinnati, OH 45263-1025
$184.45
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 5003361296 I 42-390.121 $184.45 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
Wednesday, July 29, 2015
Director, Brookshire off 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))
07/28/15 5003361296 Safety Supplies $184.45
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