186468 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH BROOKSHIRE GOLF CO_ %CK AMOUNT: $52.45
1, CARMEL, INDIANA 46032 C/O PAM LISTER
CHECK NUMBER: 186468
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 52.45 FOOD BEVERAGES
Woae)r
Right Store. Right Price.
1217 S. RANGELINE RD.
317 -846 -4818
YOUR CASHIER WAS VICCI
SCHWP TONIC 1.49 F
SCHWP TONIC 1.49 F
SCHWP TONIC 1.49 F
SCHWP TONIC 1.49 F
SCHWP TONIC 1.49 F
KROGER PLUS CUSTOMER *7476
TAX 0.00
BALANCE 7.45
021 KROGER 4959
1217 S. RANGELINE RD,
CARMEL IN 46032
CREDIT CARD Purchase
*1516
TOTAL: 7.45
REFit: 061430
CREDIT CARD 7.45
CHANGE 0.00
TOTAL NUMBER OF ITEMS SOLD 5
05/28/10 08:53am 959 10 41 183
Wa 1I rn
Save money.,l_ive better.
MANAGER CHRIS HAGI-'MEIER
317 844 0096
ST# 1601 OP# 0000.5250 'rE# 14 7R# 03
LATCH BOX 0073149921356 9.00 X
LATCH BOX 007314992856 9.00 X
LATCH BOX 007314992856; 9.00 X
LATCH BOX 0073149921356 9.60 X
LATCH BOX 007314992356 9.00 X
SUBTOTAL 4.'.00
TAX 1 7.000 X 3.15
101AL 48.15
MCARD TI 48.15
ACCOUNT #1516
APPROVAL 9076310
CHANGE DUE 0.00
ITEMS SIOILID 5
TC# 7853 0358 0300 2920 5067
We want you to Pay the lowest Fl6 °ic:e.
Ask about our Price watch Policy.
05/27.110 23:27;16
*CIJSTOMER COP'P
PrescAbed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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))
e S
Total S;
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
�j£i Er
n 7 4�6 4 �z�r✓J
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Jo70 3 90 yq 0 bill(s) is (are) true and correct and that the
90- �(S' materials or services itemized thereon for
which charge is made were ordered and
received except
d— 20 D7
S' nat e
Cost distribution ledger classification if tle
claim paid motor vehicle highway fund