249847 09/23/15 CITY OF CARMEL, INDIANA VENDOR: 358941
® ONE CIVIC SQUARE PETTY CASH - BROOKSHIRE GOLF COUAIJECK AMOUNT: $"""'.***35.03'
�. ?a CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 249847
CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 15.43 FOOD & BEVERAGES
1207 4342100 19.60 POSTAGE
ENTENMANNS BAKERY OUTLET
6935 D LAKE PLAZA DRIVE
INDIANAPOLIS IN
(317)570-1741
10:48AM Sep 11/15-
00-7514 001 CINDY,
#17243
6.000 ® $1 .30
BB 24oz 100%WWWP Fl$'7.80
4cTTL $7.80 ,.
CASH $10.00.:'
CHANGE $2.20
THANK YOU FOR SHOPPING
AT ENTENMANNS BAKERY
OUTLET STORES
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))
09/11/15 I Entenmann's I Food I $7.80
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
Petty Cash
IN SUM OF $
$7.80
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE FATUNT Board Members
1207 I Entenmann's I 42-390.40 I $7.80 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, September 11, 2015
4 ly
Director, Brookshi Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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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))
09/14/15 I O'Malia I Stamps I $19.60
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
Petty Cash
IN SUM OF $
$19.60
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I O'Malia I 43-421.00 I $19.60 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
Tuesday, September 15, 2015
Director, Brook ire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Self Checkout ,
CLUB MANAGER RYAN SIMPSON
(317) 585-1619
INDIANAPOLIS, IN
09/10/15 11 :39 7393 :08168 0909 90
KATHY VASIL
E 419539 WHEAT BREADF • 5.38 N
SUBTOTAL 5.38
TOTAL. 5.38
MCARD TEND 5,38
ACCOUNT # **** **** **** 2261 S
i APPROVAL # 61754P
TERMINAL # 099745269
CHANGE DUE 0.00
Visit samsclub.com to see Hour savings
ITEMS SOLD 1
TC# 7736 5167 9210 6047 3065
'II Illli. III' Ili II IIII illll IIID II III'il'lll'I II III II
Please tell us about your shopping experience
http://vAw�.survey.sam scl uh.com
IN RETURN FOR YOUR TIME YOU COULD RECEIVE
ONE OF FIVE$1,000 SAM'S CLUB SHOPPING CARDS
Must be 18 or older and a legal resident of the 50 US or
DC to enter.No purchase necessary to enter or win.To
enter without purchase and for official rules visit:
wwvv.entry.su ivey.samsehu b.oom
Sweepstakes period ends on the date shown in the
official rules.Survey must be taken within
TWO weeks of today.
Esta encuesta tambi6n se encuentra en espanol an la
pigina de Internet.
Happy t® Help
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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))
09/10/15 Sam's Bread $5.38
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
Petty Cash
IN SUM OF $
$5.38
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE FTMOUNT
Board Members
1207 I Sam's I 42-390.40 I $5.38 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
Thursday, September 10, 2015
Director, Brookshire If Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I INVOICE
CITY OF CARMEL
dba BROOKSHIRE GOLF CLUE
Q 1212+;'.1 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.Q. Box 2856
Kokomo, IN 46904-2856 RP27 542 EXP. 1C.011,5?'t5
765-459-3117
800-382-0675
Fax: 765-457-7967
' BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
09/03/15 617852 Dustin Smith 13 BOO 13
BASE September 29, 2014
PROMO #0915 C�
WINE:W3428870 "
109 S ® Bud 24 Can r�/�% ��O✓`�, 94
208 12Bud Lt 2/12 Can 17.55 \ O 210
225 i ®" Bud Lt 1/4 BBL 53. 50 30.00 83
7025 2 —'' Goose 312 2/12 Can 25. 55 . 51
NVO74"
N a W e AV Q&W_=�E=—,:�==
Cases 19 1/4 Barre I sC!1STOMER OLIVES `�
TOTAL SALE 438
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00
10405 EMPTY AB 1/4 30.00 A '
10301 EMPTY CROWN 1/4 SBL 30.00
9230 PUMP DEPOSIT IN
Q t I
9270 IMPORT PUMP DEPOSITON
3B
CREDITS
❑ Cash ❑ EFT ❑ Escrow Check Number
Driver �� Received By I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF $
$2.25
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 617852 I 42-390.40 I $2.25 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
Thursday, September 10, 2015
I
Director, Brook Golf 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))
09/03/15 I 617852 I Miss charge on Beer I $2.25
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 # 153117 WARRANT # ALLOWED
241763 IN SUM OF $
PETTY CASH - ADMIN
C/O LISA
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
092115 01-6200-08 $12.99
092115 01-6500-05 $75.98
092115 01-6750-08 $50.46
Voucher Total $139.43
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
241763
PETTY CASH -ADMIN Purchase Order No.
C/O LISA Terms
Due Date 9/17/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/17/2015 092115 $139.43
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
Date fficer