249370 09/09/15 °�'��Ab
F, CITY OF CARMEL, INDIANA VENDOR: 361198
`'si. CHECK AMOUNT: $**.....182.16
.� ® �, ONE CIVIC SQUARE NIKE USA INC
,. ?� CARMEL, INDIANA 46032 PO BOX 847648 CHECK NUMBER: 249370
9M�<<ON roe DALLAS TX 75284-7648 CHECK DATE: 09/09115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 975275620 182.16 GOLF SOFTGOODS
. . NIKEGOLF &/ Customer Number: 272920 Invoice Number: 975275620
Nike Order Number: 707841071 Invoice Date: 08/19/2015
INVOICE Nike Delivery Number: 352465476 Terms: Net 60
Customer PO No: TEAM Terms begin as of: 08/19/2015
Ordered by: Due Date: 10/18/2015
DUNS#:05-095-7364 Ordered on: 08/18/2015 Currency: USD
FEDERAL TAX ID#:93-124-3023
Original Invoice Number:
MAIL TO DELIVER GOODS TO
CITY OF CARMEL CITY OF CARMEL
BROOKSHIRE GOLF CLUB 12120 BROOKSHIRE PKWY
12120 BROOKSHIRE PKWY BROOKSHIRE GOLF CLUB
CARMEL IN 46033-3314 CARMEL IN 46033-3314
Material Customer Product Description Size UOM�QuantityjQuantityj Wholesale I Net Unit Total
Product Code]. Ordered ShippedUnit Price Price
640371-100 VICTORY SLEEVELESS POLO XS EA 5 5 22.50 19.12 95.60
S EA 4 4 22.50 19.12 76.48
"Subtotals 9 9 202.50 172.08 172.08
Shipped From: Nike Golf: Memphis
Date Shipped: 08/19/2015
Order Type: At-Once Order
Direct Ship Factory PO#:
Carrier: Federal Express
Mode of Transport: Standard
Incoterms: Free carrier
Weight: 4.280;
Bill of Lading Number:
Pro number:
Tracking Number: 217508289573416;
Packing list Number: 17796268
Number of Cartons: 1
Special Label Instructions:
Store ID:272920
Wholesale Amount Sales Net of Discount Freight Total
202.50 172.08 10.08 182.16
All Nike USA.Inc.products are sold FCA(Free Carrier-Shipping Point)and payment terms are calculated from invoice date unless specifically noted otherwise by
Nike. A service charge of 1 'h% er month will be charve&on all past due invoices. Anticipation discounts are not allowed. No returns without prior
authorization from Nike. Shortage claims must be made within 30 days of receipt. All collection fees and costs must be paid by purchaser. Detailed terms and
conditions on reverse side of page 1.
Please remit to: NIKE USA, Inc.
PO Box 847648
Dallas TX 75284-7648 US
Page 1 of 3
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))
08/19/15 975275620 Soft Goods $182.16
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
Nike USA, Inc.
IN SUM OF $
P.O. Box 847648
Dallas, TX 75284-7648
$182.16
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 975275620 I 43-560.06 I $182.16 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, August 26, 2015
44 V
Director, Brookshire If Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund