301650 08/08/16 +ui_GiRM
CITY OF CARMEL, INDIANA VENDOR: 343500
4 Q5 til ONE CIVIC SQUARE CINTAS FIRST AID&SAFETY CHECK AMOUNT: $*******192.88*
CARMEL, INDIANA 46032 CINTAS CORPORATION CHECK NUMBER: 301650
PO BOX 631025 CHECK DATE: 08/08/16
CINCINNATI OH 45263-1025
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239012 5005667065 192.88 SAFETY SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
CINTAS FIRST AID & SAFETY ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 631025 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CINCINNATI, OH 45263-1025 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$192.88 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Course Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
5005667065 42-390.12 $192.88 1 hereby certify that the attached invoice(s),or 7/28/16 5005667065 First-aid supplies $192.88
1207 101 1207 101
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,July 29,2016
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
cl 1
� SVC/BILLING QUESTIONS: 317-264-5103
READY FORNEWnWORMW FAX : 317-644-0870
1435 Brookville Way PAYMENT INQUIRY : (888)994-2468
Indianapolis, IN 46239 ROUTE # : LOC #0388 ROUTE 0005
INVOICE
PLEASE PAY DIRECTLY FROM THIS INVOICE
BROOKSHIRE GOLF CLUB INVOICE # : 5005667065
12120 BROOKSHIRE PKWY DATE_-_ 7/28/16
CARMEL, IN 46033-3314 PO # :N/A
317-846-7431 CUSTOMER # : 0010069450
PAYER # : 0010087731 3
Y
SVC ORDER # : C@113F8FD
CREDIT TERMS:NET 10 DAYS 1'
MATERIAL # DESCRIPTION QTY UNIT PRICE EXT 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
44249 ELASTIC STRIP SMALL 1 $6.61 $6.61
55556 DISINFECTANT WIPE 1 $5.95 $5.95
100039 TRIPLE ANTIBIOTIC OINT SM 1 $8.86 $8.86
101239 FIRST AID CREAM SMALL 1 $7.58 $7.58
111329 ACETAMINOPHEN SM 1 $9.98 $9.98
111529 PAIN AWAY X-STRENGTH SM 1 $10.88 $10.88
111929 IBUPROFEN TABS SMALL 1 $11.63 $11.63
UNIT,SUBTOTAL $73.44
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
100439 HYDROCORTISONE CREAM SM 1 $7.63 $7.63
111599 PAIN AWAY X-STRENGTH LRG 1 $32.60 $32.60
111989 IBUPROFEN TABS MEDIUM 1 $18.85 $18.85
119250 ANTI-DIARRHEAL"CAPLETS SM 1 $14.12 $14.12
119260 ALLERGY RELIEF TABLET MED 1 $19.59 $19.59
280020 LENS/SCREEN PADS 100/BX 1 $20.70 $20.70
UNIT SUBTOTAL $119.44
REMIT TO :Cintas SUB-TOTAL $192.88
P.O. Box 631025 TAX $0.00
CINCINNATI, OH 45263-1025 TOTAL $192.88
SIGNATURE -'� DATE
NAME
Page 1 of 1 INVOICE # 5005667065 PAYER # 0010087731.