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308730 02/28/17 CITY OF CARMEL, INDIANA VENDOR: 358941 ONE CIVIC SQUARE PETTY CASH- BROOKSHIRE GOLF COURUICK AMOUNT: S"'*"'"44.62' (9, CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 308730 CHECK DATE: 02/28/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 5.42 FOOD & BEVERAGES 1207 4342100 39.20 POSTAGE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 358941 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 $5.42 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 O'Malia 42-390.40 $5.42 I hereby certify that the attached invoice(s),or 2/24/17 O'Malia Food $5.42 1207 101 1207 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, February 27,2017 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 358941 PETTY CASH -BROOKSHIRE GOLF COURSE IN SUM OF$ 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 $39.20 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 US Postal Service 43-421.00 $39.20 1 hereby certify that the attached invoice(s),or 2/21/17 US Postal Service Stamps $39.20 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, February 27,2017 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