308352 02/17/17 t,`yi�.C�A�f
�,r �� CITY OF CARMEL, INDIANA VENDOR: 358941
® ONE CIVIC SQUARE PETTY CASH -BROOKSHIRE GOLF COUAI9ECK AMOUNT: $..... "191.92'
,. ,;4 CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 308352
9�',�TtiB fib` CHECK DATE: 02/17/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 191.92 FOOD & BEVERAGES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 358941 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PETTY CASH -BROOKSHIRE GOLF COURSE IN SUM OF$ CITY OF CARMEL
C/O PAM LISTER 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
$191.92
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
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
Bed Bath& 42-390.40 $191.92 1 hereby certify that the attached invoice(s),or 2/15/17 Bed Bath& Serving dishes $191.92
Beyond Beyond
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
Wednesday, February 15,2017
(A /I Z
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