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Home My WebLink About305640 11/28/16 0�F�q ,% � CITY OF CARMEL, INDIANA VENDOR: 358941 ® ONE CIVIC SQUARE PETTY CASH- BROOKSHIRE GOLF COURIJECK AMOUNT: $''"""166.43' ,. _� CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 305640 'tii�ioN�� CHECK DATE: 11/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4230200 137.98 OFFICE SUPPLIES 1207 4239040 28,45 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) PETTY CASH -BROOKSHIRE GOLF COURSE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER C/O PAM LISTER IN SUM OF$ 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. $137.98 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 Jim Rodgers 42-302.00 $137.98 1 hereby certify that the attached invoice(s),or 11/17/16 Jim Rodgers Funeral Flowers $137.98 Flowers Flowers 1207 101 bill(s)is(are)true and correct and that the 1207 101 materials or services itemized thereon for which charge is made were ordered and received except Thursday, November 17,2016 l 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— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Order#W00835417821499 MOM continue si'67p �I Recipient : JIM RODGERS Thoughts and Prayer Fireside Basket-Peach, Orange,and White Mixed Fireside Basket Item:#91203 Qty: 1 Price: $119.99 Shipping Address: JIM RODGERS 200 N 7TH ST GAS CITY, IN 46933 765-674-4400 Gift Message: Love and prayers from your Brookshire Golf Club family. Delivery: NA Estimated Arrival On or before: 11-19-2016 Item Sub Total: $119.99 Billing Address PAMELA LISTER 11598 MANSFIELD PL CARMEL, IN 46032 pllister@msn.com 317-201-7964 Payment Information Payment Method: Credit Card VI *********"'8159 $137.98 Order Payment Summary Promotion Discount: $0.00 Shipping Charge: $17.99 Tax: $0.00 Order Total: $137.98 VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) PETTY CASH -BROOKSHIRE GOLF COURSE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER C/O PAM LISTER IN SUM OF$ 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. $28.45 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 Hobby Lobby 42-390.40 $10.95 1 hereby certify that the attached invoice(s),or 11/18/16 Walmart Cleaning Supplies $17.50 1207 101 1207 101 Walmart 42-390.40 $17.50 bill(s)is(are)true and correct and that the 11/18/16 Hobby Lobby Containers $10.95 1207 101 1 materials or services itemized thereon for 1207 101 which charge is made were ordered and received except Friday, November 18,2016 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer See back.of receipt for sour chance to win $1000 ID #: 7KO86SKBK65 --------------------------------------- Wa I m ai r t `'#.. Save money.Live better. ( 317 ) 844 - 0096 MANAGER KYLE LANGSTON 2001 E 151ST ST CARMEL IN 46033 ST# 01601 OP# 006980 TE# 12 TR# 04543 2PC SPATULA 001634690084 1 .97 0 LM FRDM RF 007173604003 6.48 0 DAWN SIMPLY 003700017220 3.74 0 MR, CLEAN 003700016356 2.47 0 SCRBB FM BLE 002570070809 2.84 0 SUBTOTAL 17.50 - TOTAL 17.50 DEBIT TEND 17.50 CHANGE DUE 0.00 EFT DEBIT PAY FROM PRIMARY 17.50 TOTAL PURCHASE US DEBIT **** **** **** 8159 I 0 . REF # 632300067779 NETWORK ID. 0056 APPR CODE 441665 US DEBIT AID A0000000980840 TC AFFB393084485CED *Pin Verified TERMINAL # MX559580 11/18/16 13:31 :20 # ITEMS SOLD 5 TC# 5514 1937 5911 8007 3168 11111111111111111111111111111111111 IN IIIIIII IIII III III III IIIIIII IIIII III I I III III 11/18/16 13:31 :35 Store receipts on sour phone. Walmart P au, 0 HOBBY LOBBY Super Sowings,Super Selection! 2003 E, Greyhound Pass Carmel , IN 46033 Hobby Lobby Store #182 (317) 818-9217 S-182 R-5 T-1604 KAREN M SALE 105000000 Crafts 5.97 N 50 % Off (3.99-2.00) 3 ® 1.99 ea 106500000 Floral 4.98 N 50 % Off (4.99-2.50) 2 @ 2.49 ea SUBTOTAL 10.95 TAX TTOTAIL 10 . 95 0.00 AO�EX MP CUSTOMER l O . 95 DEBIT 10.95 ACCOUNT #: w*w—w---8159 AUTH#: REF#: 6323115904 CHANGE DUE 0.00 Number of Items Purchased: 5 Total savings: 11.00 Thank You. Please come again. Become a fan on Facebook. Return Policy on back of receipt Visit our website at www.hobbylobby.com I IIIIIIIIIIII IIIIIIII II II IIII IIII N 0182005016041118169 11/18/16 12:57 PM --Continued on Side 2--