185247 05/11/2010 a CITY OF CARMEL, INDIANA VENDOR: 361858 Page 1 of 1
0 ONE CIVIC SQUARE FOREI RESERVATIONS INC
CARMEL, INDIANA 46032 5019 GRAND AVENUE CHECK AMOUNT: $1,900.00
WESTERN SPRINGS IL 60558 CHECK NUMBER: 185247
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4351502 39011 1,900.00 SOFTWARE MAINT CONTRA
Fare! Rdservations, Inc.
5019 Grand Avenue
Western Springs, IL 60558 Invoice
Date Invoice #a'
5/1/2010 39011
Bill To
Brookshire Golf Club
12120 Brookshire Parkway
Carmel, IN 46033
P.O. No. Terms Representative
20693 Due on receipt CMS
Quantity Description Unit Price Amount
1 Dell PA DSS Black Box Computer 1,250.00 1,250.00
1 PA DSS On -Line Training and Upgrade 650.00 650.00
Total $1,900.00
Make all checks payable to: Fore! Reservations, Inc.
If you have any questions concerning this invoice, please call our Accounts Receivable
Department at 630.789.9705 ext. 111
Thank you for your Business
INDIANA RETAIL TAX EXEMPT PAGE
C of C arme l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
f FEDERAL EXCISE TAX EXEMPT
35- 60000972 U
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AJP
CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR �IG SHIP
TO �J 2& l -t aG /12- PK
CONFIRMATION BLAN T 'CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
/r/�Juj
PLEASE INVOICE IN DUPLICATE,
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT F r AMOUNT
PAYMENT .9 ,1 al CJ_c�:
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED,
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS,APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
llt
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY I f lo
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
b CLERK TREASURER
DOCUMENT CONTROL NO. A COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SLIM OF
ON ACCOUNT OF APPROPRIATION FOR
6r'b
Board Members
PO# or
DEPT. INVOICE NO, ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the 1
materials or services itemized thereon for
which charge is made were ordered and
received except
lI�cwl 20 0
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Title
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Cast distribution ledger classification if
claim paid motor vehicle highway fund