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303423 09/26/16 r Cqq ® \ CITY OF CARMEL, INDIANA VENDOR: 359984 ; ONE CIVIC SQUARE INDIANA GOLF CAR CHECK AMOUNT: $********44.42* CARMEL, INDIANA 46032 1770 B EAST 266TH STREET CHECK NUMBER: 303423 ARCADIAIN 46030 CHECK DATE: 09/26/16 t«ONS DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4350000 8818 44.42 EQUIPMENT REPAIRS & M VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) INDIANA GOLF CAR ALLOWED .20 ACCOUNTS PAYABLE VOUCHER 1770 B EAST 266TH STREET IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service ARCADIA, IN 46030 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $44.42 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 8818 43-500.00 $44.42 1 hereby certify that the attached invoice(s),or 91716 8818 Equipment Repairs $44.42 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 Monday, September 12, 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 5-11-10-1.6 120— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana Golf Car,Inc. Invoice 1770 B E 266th Arcadia,IN 46030 Date Invoice# 9/7/2016 8818 Bill To Ship To BROOKSHIRE G.C. BROOKSHIRE G.C. 12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY. CARMEL,IN 46033 CARMEL,IN 46033 P.O. Number Terms Rep Ship Via F.O.B. Project RUSSELL Net 30 9/7/2016 Quantity Item Code Description Price Each Amount 1 AM10682 TIRE,UNMOUNTED 44.42 44.42 THANK YOU FOR CHOOSING INDIANA GOLF CAR Total $44.42