250169 10/07/15 r C_._1A .
c!
f CITY OF CARMEL, INDIANA VENDOR: 197000
it ONE CIVIC SQUARE CINTAS CHECK AMOUNT: $ ....'174.00-
CARMEL,;? CARMEL, INDIANA 46032 PO BOX 631025 CHECK NUMBER: 250169
'1„iroN�, CINCINNATI OH 45263-1025 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239012 5003733308 174.00 SAFETY SUPPLIES
----------------------------
P
wROWO&S FAS Svc/Billing Questions: 317-264-5103
MW 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 # 5003733308
12120 BROOKSHIRE PKWY DATE 9/24/15
CARMEL, IN 46033-3314 PO # N/A
317-846-7431 CUSTOMER # 0010069450
PAYER # 0010087731
SVC ORDER # C@15F698A
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 $11 .95 $11 .95
50030 ANTISEPTIC WIPES SMALL 1 $5 .63 $5 .63
55556 DISINFECTANT WIPE 1 $5 .95 $5 .95
72240 ROLLER GAUZE, 4" NON-STER 1 $6 .35 $6 .35
100439 HYDROCORTISONE CREAM SM 1 $7 .63 $7 .63
119260 ALLERGY RELIEF TABLET MED 1 $19 .59 $19 .59
163050 BURN RELIEF PACKET/ 6 PK 1 $13 .43 $13 .43
280020 LENS/SCREEN PADS 100/BX 1 $20 .70 $20 .70
UNIT SUBTOTAL $91 .23
466845 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
132 BBP KIT CHECKED 1 $0 .00 $0 .00
55556 DISINFECTANT WIPE 1 $5 .95 $5 .95
72240 ROLLER GAUZE, 4" NON-STER 2 $6 .35 $12 .70
80479 1/2" X 5 TAPE DISPENSER 1 $5 .60 $5 .60
111329 ACETAMINOPHEN SM 1 $9 .98 $9 .98
111929 IBUPROFEN TABS SMALL 1 $11 .63 $11 .63
130479 EYEWASH, 1/202 MEDIUM 1 $16 .21 $16 .21
280020 LENS/SCREEN PADS 100/BX 1 $20 .70 $20 .70
UNIT SUBTOTAL $82 .77
-----------------
e 0
n ianapo is 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 $174 .00
PO BOX 631025 TAX $0 .00
CINCINNATI, OH 45263-1025 TOTAL $174 .00
SIGNATURE: ------------------------------ DATE: ------------------
NAME:
------------------------------
I
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))
09/24/15 5003733308 Safety Supplies $174.00
1 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
Cintas Corporation
fl IN SUM OF $
P.O. Box 631025
Cincinnati, OH 45263-1025
$174.00
�A
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
i
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 5003733308 I 42-390.12 I $174.00 I 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 25, 2015
Director, Brooksh e Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund