185222 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 361032 Page 1 of 1
ONE CIVIC SQUARE DYNA SYSTEMS CHECK AMOUNT: $76.04
CARMEL, INDIANA 46032 P 0 BOX 971342
DALLAS TX 75397 -1342 CHECK NUMBER: 185222
OM
CHECK DATE: 5/11/2010
DEPARTMENT i ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 20359148 76.04 EQUIPMENT REPAIRS M
Dyna Systems SHIP TO Invoice
P.O. Box 655326 FBROOKSHIRE GOLF CLUB
Dallas, TX 75265 -5326
{8001 33 6-0456 RUSSEL PICKETT 1 of 1
12120 BROOKSHIRE PKWY
NCH Corporation CARMEL, IN 46033
9 p01 pee
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BILL TO REMIT TO: PO BOX 971342 o`O
BROOKSHIRE GOLF CLUB DALLAS TX 75397 -1342 'cJr �Numb e s
BOB HIGGINS "Distribution services include shipping and handling
1 21 20 BROOKSHIRE PKWY charges. Returned merchandise not accepted without
CARMEL IN 46033 return goods authorization. All return claims for errors
or adjustments of any kind must be made within 15
days after receipt of goods.
INVOICE INVOICE DATE CUSTOMER CUSTOMER P/O DUE DATE
20359148 04/27/1 DY305524 RUSSEL 05/27/10
ORDER SHIP DATE SALES REP RELEASE SHIP VIA
203 .06883 -7_ _0.4/2.7_/1.0__ __D202. D202!1165_ FED EX G ROUND
FOR REORDERS CALL 1- 800 336 -0450 FAX 1- 972 -721 -6870
PAR?. Nc .D1 SCF7i# CION12E E*KG ..::CITY BtJ CITY SF#I?.; UNIT!f'�tECE .;I EXT AMOUN
DY00421333 CAP SCREW SIX SHOOTER EA 0 50 9.47
DY00421345 CAP SCREW SIX SHOOTER EA 0 25 8.59
DY03021700 WASHER FLAT USS DOMESTIC EA 0 50 7.16
DY03022500 WASHER FLAT USS DOMESTIC EA 0 25 6.33
DY20038400 BUTT CONNECTOR BLUE NYL I EA 0 50 16.85
DY20038300 BUTT CONNECTOR RED NYLON EA 0 50 16.85
SUB -TOTAL DISCOUNT MIN ORDER CHG SALES TAX *SHIPPING TOTAL
65.25 0.00 10.79 AMOUNT 76.04
TO INSURE PROPER CREDIT, PLEASE DETACH HERE AND MAIL BOTTOM PORTION WITH YOUR PAYMENT.
VOUCHER NO. WARRANT NO.
ALLOWE D 20
Dyna Systems
IN SUM OF
P.O. Box 971342
Dallas, TX 75397 -1342
$76.04
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 20359148 43- 500.00 $76.04 1 hereby certify that the attached invoice(s), or
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
Thursday, May 06, 2010
Director, BrookA a Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 199:
ACCOUNTS PAYABLE VOUCHER
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/27/10 20359148 Repair Parts $76.0
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
Clerk- Treasurer