185660 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 363613 Page 1 of 1
s` Q ONE CIVIC SQUARE BOB'S CO2
r CARMEL, INDIANA 46032 1750 W HUNTSVILLE ROAD CHECK AMOUNT: $35.00
PENDLETON IN 46064 CHECK NUMBER: 185660
CHECK DATE: 5126/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 1380 35.00 FOOD BEVERAGES
13015 CO L.L.C. DELIVERY TICKET N®. 1 3
"I've Got Gas"
1750 W. Huntsville Road
Pendleton, IN 46064
Date:
317 -969 -9262 765 -778 -8463
Y
q_
to Criy. Unit Description Hazard Class Item Cylinders Volume Unit, Extended Amount
Ship Ship Return Weight Amount
1
jL- 6 7. (D
2
3
4
5
6
7
8
9
IO
IMPORTANT
PLEASE READ CAREFULLY THE TERMS AND CONDITIONS OF SALE WHICH APPEAR ON THE FREIGHT
REVERSE SIDE OF THIS DOCUMENT. ALL SALES ARE SUBJECT TO SUCH TERMS AND
SALES TAx
CONDITIONS. CUSTOMER SIGNATURE HEREON VERIFIES SHIPPED AND RETURNED RENTAL
CYLINDER COUNT. c
TERMS AND CONDITIONS: THE CUSTOMER HEREIN CONSENTS TO AND ACCEPTS THE ABOVE PRODUCTS SUBJECT TO ALLOF THE CONDITIONS ASSET
FORTH ON REVER ESIDE HEREOF A D THEE STING CONTRACT BETWEEN BOTH PARTIES.
Receiv y (sign re)
X Date
Shipped By
WHITE COPY- OFFICE YELLOW COPY CUSTOMER
'VOUCHER NO. WARRANT NO.
Bob's CO2, L.L.0 ALLOWED 20
IN SUM OF
1750 West Huntsville Road
Pendleton, IN 46064
$35.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1207 1380 42- 390.40 $35.00 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
Monday, May 24, 2010
/!may
Director, Brook hire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Stale 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))
05/20/10 1380 CO2 $35.G
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