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Home My WebLink About159776 05/28/2008 4 CITY OF CARMEL, INDIANA VENDOR: 361044 Page 1 of 1 ONE CIVIC SQUARE ASHWORTH INC CHECK AMOUNT: $2,816.41 CARMEL, INDIANA 46032 FILE 51141 LOS ANGELES CA 90074 -1141 CHECK NUMBER: 159776 CHECK DATE: 5/2812008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 905 4356006 042720 48.42 GOLF SOFTGOODS 905 4356006 044941 228.78 GOLF SOFTGOODS 905 4356006 045132 2,310.55 GOLF SOFTGOODS 905 4356006 050616 228.66 GOLF SOFTGOODS DATE REMIT TO: A shw o rth 4/14/08 042720 REMIT T INC FILE 51141 0 0 LOS ANGELES, CA 900741141 0017128 6/13/08 For Order Questions 800 627 -4274 Callaway Golf Apparel For Credit Questions 888 633 -7242 NET 60 DAYS We accept Checks Over the Phone, Visa MasterCard Please call 888 633 -7242 lo B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY I 12120 BROOKSHIRE PKWY CARMEL, IN 46033 P CARMEL, IN 46033 T T 0 0 B/O PUD KERRMIK J UPS GROUND SERVICE 1 2.00 00000 Callaway Golf Apparel FLAT FRONT SHORT 1 35.00 21.00 21.00 CX65138 BLACK 38 40 42 44 1 Callaway Golf Apparel FLAT FRONT SHORT 1 35.00 21.00 21.00 CX65138 PUTTY 38 40 42 44 To tal Unit 2 "6!S o s 448 70.00 28.00 .00 00 6.42 48.42 E MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B.- SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2766 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 1 FROM: ASHWORTH, INC. 2791 LOKER AVENUE WEST CARLSBAD, CA 92008 PHONE: 800 627 -4274 FAX: 619- 438 -6657 Ills Callaway Golf Apparel BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB GOLF SHOP GOLF SHOP 12120 BROOKSHIRE PKWY 12120 BROOKSHIRE PKWY CARMEL, IN 46033 CARMEL, IN 46033 ;0017:128 ;=B/O 553448 UPS NET 60 DAYS GOLF SHOP PUD 1/25/08 4/06/08 4/16/08 KERRMIK MIKE KERR B o ne 30 32 33 34 35 36 38 40 42 44 267268 CX 65138 BLACK AAA FLAT FRONT SHOR 1 1 267268 CX 65138 PUTTY AAA FLAT FRONT SHOR 1 1 TAG:B /O PIECES myit Ai s e o 101 zi re 1 0 /00 /00 RPC 2 1 UPS GROUND SERVICE Callaway Golf is a trademark of Callaway Golf Company, Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. page 1 PACKSIAP* Ashworth Ashworth, Callaway, Sunice Apparel CHANGE OF REMITTANCE ADDRESS Please be advised the correct remittance. (FOR PAYMENTS ONLY) address is the following. By Mail: Ashworth Inc File 51141 Los Angeles CA 90074 -1141 (This is a bank lockbox) By EFT or Wire: Bank of America New York 100 West 33rd Street New York, NY 10001 ABA Routing 026009593 Swift Code: BOFAUS3N Account 14598 -40525 C /O: Ashworth, Inc. For Purchase Orders, and all other correspondence please mail Ashworth, Inc 2765 Loker Ave West Carlsbad, CA 92010 Returns send to with a Return Authorization: 4010 Ocean Ranch Blvd Oceanside, CA 92056 2765 Loker Ave West.: Carlsbad CA 92010 760- 438 -6610 Brookshire Golf Club Inventory Received Report 12120 Brookshire Parkway Order Number: 05112008-21 Carmel, IN 46033 Received Order Number A6nd6d 110 TM WOfd6r Item aTdl �T T 6 k" V& d '6 a �17 aaj 3003171 CLWY MENS SHORTS P 2 2 0 $24.21 $48.42 $0.00 pi n 12420 2 M Grand Totals: Authorized by Date Order Number: 05112008-21 Page 1 of 1 REMIT TO: 4/16/08 045132 ASHWORTH, INC. Ashworth FILE 51141 LOS ANGELES, CA 900741141 0017128 6/15/08 For Order Questions 800 627 4274 Callaway Golf Apparel For Credit Questions 888 633 -7242 NET 60 DAYS We accept Checks Over the Phone, Visa MasterCard Please call 888 633 7242 B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY 1 12120 BROOKSHIRE PKWY L CARMEL, IN 46033 P CARMEL, IN 46033 T T 0 O CUST OMER P.O. KERRMIK UPS GROUND SERVICE 2 43.00 00000 e SIZE SCALE e Callaway Golf Apparel ZIP FRONT POLO W/ SELF COLLAR 4 37.00 .00 148.00 CX16570 WHITE S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel 2 -BTTN HIDDEN PLKT POLO 4 37.00 .00 148.00 CX16571 WHITE S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel ENG STRIPED 2 -BTTN POLO 4 37.00 .00 148.00 CX16575 STPHR S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel ENG STRIPED 2 -BTTN POLO 4 37.00 .00 148.00 CX16575 WHITE S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel L IS V- NECK PULL -OVER 3 45.00 .00 135.00 CX25223 BLACK S M L XL XXL 1 1 1 EMB 2.50 7.50 Callaway Golf Apparel L IS V- NECK PULL -OVER 2 45.00 .00 90.00 CX25223 BLAZE S M L XL XXL 1 1 EMB 2.50 5.00 Callaway Golf Apparel L IS V- NECK PULL -OVER 3 45.00 .00 135.00 CX25223 OLYMB S M L XL XXL 1 1 1 EMB 2.50 7.50 C O N T I N U E D s-� EMBROIDERY SHIP e •e TOTAL 377979 556484 ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B.- SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Cadsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 1 e REMIT TO: 4/16/08 045132 ASHWORTH, INC. Ashworth,,. FILE 51141 e LOS ANGELES, CA 900741141 0017128 6/15/08 For Order Questions 800 627 4274 Callaway Golf Apparel For Credit Questions 888 633 -7242 PAYMENT TERMS NET 60 DAYS We accept Checks Over the Phone, Visa MasterCard Please call 888 633 -7242 B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY I 12120 BROOKSHIRE PKWY L CARMEL, IN 46033 P CARMEL, IN 46033 T T O O CUSTOMER o KERRMIK UPS GROUND SERVICE 2 43.00 00000 Os ma n e UNITS PRICE PRICE Callaway Golf Apparel L IS V- NECK PULL -OVER 2 44.00 .00 88.00 CX25223 SYNRG S M L XL XXL 1 1 EMB 2.50 5.00 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 4 35.00 .00 140.00 CX16493 APRCT S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 4 35.00 .00 140.00 CX16493 BKBLZ S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 4 35.00 .00 140.00 CX16493 KIWI S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 4 35.00 .00 140.00 CX16493 NAUTN S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 1 35.00 .00 35.00 CX16493 OLYMB S M L XL XXL 1 EMB 2.50 2.50 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 6 35.00 .00 210.00 CX16493 OLYNN S M L XL XXL 1 2 2 1 EMB 2.50 15.00 C 0 N T I N U E D e-e IP EMBROIDERY TOTAL 'e e LING 377979 556484 ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B.- SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 2 DA REMIT TO: 4/16/08 045132 ASHWORTH, INC. FILE 51141 LOS ANGELES, CA 900741141 0017128 6/15/08 For Order Questions 800 627 -4274 Callaway Golf Apparel MS For Credit Questions 888 633 -7242 NET 60 DAYS We accept Checks Over the Phone, visa MasterCard Please call 888 633 -7242 B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY F 12120 BROOKSHIRE PKWY CARMEL, IN 46033 CARMEL, IN 46033 T T O 0 'CUST OMER o NUMBER VIA NO.OF -CART KERRMIK UPS GROUND SERVICE 2 43.00 00000 s 1 EXTENSI Callaway Golf Apparel 2 -BTTN HIDDEN PLRT POLO 4 37.00 .00 148.00 CX16571 SFTBL S M L XL XXL 1 2 1 EMB 2.50 10.00 Callaway Golf Apparel 2 BTTN S/S STRIPED POLO 4 35.00 .00 140.00 CX16493 WHTBK S M L XL XXL 1 2 1 EMB 2.50 10.00 Tot al Un its: 5 EMB ROIDERY o TAL T HANDLING 1 377979 556484 2,133.00 .00 142.50 .0 35.05 2,310.5 ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B.- SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 3 FROM: ASHWORTH, INC. 2791 LOKER AVENUE WEST CARLSBAD, CA 92008 I PHONE: 800 627 -4274 FAX: 619- 438 -6657 Callaway Golf Apparel o BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB GOLF SHOP GOLF SHOP 12120 BROOKSHIRE PKWY 12120 BROOKSHIRE PKWY CARMEL, IN 46033 CARMEL, IN 46033 o •o r• o 377979 556484 4/16/08 UPS NET 60 DAYS GOLF SHOP 0 0 0 0•® o•� e o o 0017128 11/26/07 4/01/08 5/01/08 KERRMIK MIKE KERR s S M L XL XXL r 274634 CX 16570 WHITE CPP ZIP FRONT POLO 1 2 1 j4 274634 CX 16571 WHITE CPP 2 -BTTN HIDDEN P 1 2 1 274634 CX 16575 STPHR CPP ENG STRIPED 2 -B 1 2 1 274634 CX 16575 WHITE CPP ENG STRIPED 2 -B 1 2 1 r 274634 CX 25223 BLACK CPP L IS V NECK P 1 1 1 /`i' 274634 CX 25223 BLAZE CPP L IS V- NECK P 1 1 274634 CX 25223 OLYMB CPP L IS V- NECK P 1 1 1 xU 274634 CX 25223 SYNRG CPP L IS V- NECK P 1 1 274634 CX 16493 APRCT CPP 2 BTTN S/S STRI 1 2 1 274635 CX 16493 BKBLZ CPP 2 BTTN S/S STRI 1 2 1 274635 CX 16493 KIWI CPP 2 BTTN S/S STRI 1 2 1 274635 CX 16493 NAUTN CPP 2 BTTN S/S STRI 1 2 1 274635 CX 16493 OLYMB CPP 2 BTTN S/S STRI 1 274635 CX 16493 OLYNN CPP 2 BTTN S/S STRI 1 2 2 1 6 274635 CX 16571 SFTBL CPP 2 -BTTN HIDDEN P 1 2 1 274635 CX 16493 WHTBK CPP 2 BTTN S/S STRI 1 2 1 0 r e o 0 110,11 A 4/16/08 H_A 57 2 43.00 UPS GROUND SERVICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 1 PACKSLIP Brookshire Golf Club Inventory Received Report 12120 Brookshire Parkway Order Number: 05112008-5 Carmel, IN 46033 Order Number Item' Ordere D Received d Qd�ddl�� Descript dsf Ex t ended T Receive Jye 3003160 CLWY MENS SHIRTS 47 47 0 $38.97 $1,831.5 $0.00 9 3003165 CLWY MENS SVNECK 10 10 0 $47.92 $479.20 $0.00 z E fi'd 8 9� $2,310 .W' G 57 74 Totals M— Authorized by Date Order Number: 05112008-5 Page 1 of 1 Brookshire Golf Club Inventory Received Report 12120 Brookshire Parkway Order Number: 05112008 -6 Carmel, IN 46033 Order Number Item Code Description Ordered ,To Date Receivetl Unit C ost Extended E TS 0 �Receivecl 3003481 CLWY CAP SPORT 21 21 0 $10.89 $228.69 $0.00 Grand.Totals: 21 D. X21 $10 89 °...$228:69. x_$0:00: Authorized by Date Order Number: 05112008 -6 Page 1 of 1 D 00 REMIT TO: A 4/16/08 044941 ASHWORTH, INC. FILE 51141 LOS ANGELES, CA 900741141 0017128 6/15/08 For Order Questions 800 627 -4274 Callaway Golf Apparel For Credit Questions 888 633 -7242 NET 60 DAYS We accept Checks Over the Phone, Visa MasterCard Please call 888 633 -7242 B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY 1 12120 BROOKSHIRE PKWY L CARMEL, IN 46033 P CARMEL, IN 46033 T T O 0 o VIA'� e tl o 9 KERRMIK UPS GROUND SERVICE 1 7.00 00000 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95196 PLNZA SIZE 3 EMB 2.50 7.50 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95199 NAUTN SIZE 3 EMB 2.50 7.50 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95199 ORGSN SIZE 3 EMB 2.50 7.50 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95200 NAUTN SIZE 3 EMB 2.50 7.50 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95200 STONE SIZE 3 EMB 2.50 7.50 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95200 TWILI SIZE 3 EMB 2.50 7.50 Callaway Golf Apparel SPORT -HAT 3 8.00 .00 24.00 CH95200 WHITE SIZE 3 EMB 2.50 7.50 C O N T N U E D o e o 377982 5 ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B.- SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Pa 1 REMITTO: 1 4/16/08 044941 ASHWORTH, INC. FILE 51141 LOS ANGELES, CA 900741141 0017128 6/15/08 For Order Questions 800 627 -4274 Callaway Golf Apparel ENTTERMS For Credit Questions 888- 633 -7242 PAYM NET 60 DAYS We accept Checks Over the Phone, Visa MasterCard Please call 888 633 -7242 B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY F 12120 BROOKSHIRE PKWY CARMEL, IN 46033 CARMEL, IN 46033 T T O 0 CUSTOMER e s KERRMIK UPS GROUND SERVICE 1 7.00 00000 e o- e T otal U 2 1 377982 556214 168.00 .00 52.50 .0 8.28 228.7 ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B. SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 2 FROM: ASHWORTH, INC. 2791 LOKER AVENUE WEST CARLSBAD, CA 92008 PHONE: 800 627 -4274 FAX: 619- 438 -6657 Ems BROOKSHIRE GOLF CLUB Callaway Golf Apparel o BROOKSHIRE GOLF CLUB GOLF SHOP GOLF SHOP 12120 BROOKSHIRE PKWY 12120 BROOKSHIRE PKWY CARMEL, IN 46033 CARMEL, IN 46033 e IF s ;001 556214 UPS NET 60 DAYS GOLF SHOP D o. 11/26/07 4/01/08 5/01/08 KERRMIK MIKE KERR O TAL UNITS SIZE 274636 CH 95196 PLNZA CPP SPORT -HAT 3 +3 274636 CH 95199 NAUTN CPP SPORT —HAT 3 13 274636 CH 95199 ORGSN CPP SPORT —HAT 3 274636 CH 95200 NAUTN CPP SPORT —HAT 3 3 274636 CH 95200 STONE CPP SPORT —HAT 3 j 274636 CH 95200 TWILI CPP SPORT —HAT 3 274636 CH 95200 WHITE CPP SPORT —HAT 3 V e r o e r o o 0 /00 /0.0 RPC 21 1 UPS GROUND SERVICE Callaway Golf Is a trademark of Callaway Golf Company. Ashworth, Inc.. 2785 Loker Avenue West, Carlsbad. CA 92008 is an Official Licensee of Callaway Golf Company, Page 1 VACKSLIP 'w REMIT TO: A 4/28/08 050616 ASHWORTH, INC. FILE 51141 LOS ANGELES, CA 900741141 0017128 6/30/08 For Order Questions 800 627 -4274 Callaway Golf Apparel For Credit Questions 888 633 -7242 NET 60 DAYS We accept Checks Over the Phone, Visa MasterCard Please call 888 633 -7242 B GOLF SHOP S BROOKSHIRE GOLF CLUB I BROOKSHIRE GOLF CLUB H GOLF SHOP L 12120 BROOKSHIRE PKWY I 12120 BROOKSHIRE PKWY L CARMEL, IN 46033 P CARMEL, IN 46033 T T O O e o e KERRMIK UPS GROUND SERVICE 1 8.00 00000 Callaway Golf Apparel PLAID SHORT 4 27.50 .00 110.00 CS65228 NAUTN 30 32 33 34 35 36 1 1 CS65228 NAUTN 38 40 42 44 1 1 Callaway Golf Apparel PLAID SHORT 4 27.50 .00 110.00 CS65228 WHITE 30 32 33 34 35 36 1 1 CS65228 WHITE 38 40 42 44 1 1 You have received a .00% discount for qualifying for the Spring Performance Programs. Discount is already reflected on the invoice pricing. Please pay invoiced amount by 6/30/08. Tot al Unit 8 •s o 377981 562823 220.00 .00 .00 .00 8.66 228.6 ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF GOODS. SHIPPING TERMS ARE F.O.B.- SHIPPING POINT NO RETURNS WILL BE HONORED WITHOUT WRITTEN PERMISSION AND RETURN AUTHORIZATION NUMBER. INVOICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue West, Carlsbad, CA 92008 is an Official Licensee of Callaway Golf Company. Page 1 FROM: ASHWORTH, INC. 2791 LOKER AVENUE WEST CARLSBAD, CA 92008 e PHONE: 800 627 -4274 FAX: 619- 438 -6657 Callaway Golf Apparel BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB GOLF SHOP GOLF SHOP 12120 BROOKSHIRE PKWY 12120 BROOKSHIRE PKWY CARMEL, IN 46033 CARMEL, IN 46033 'PACKING 0 e. 377981 562823 UPS ended Due Date 6/30/08 GOLF SHOP 0017128 11/26/07 5/01/08 5/31/08 KERRMIK MIKE KERR e 30 32 33 34 35 36 38 40 42 44 296419 CS 65228 NAUTN AAA PLAID SHORT 1 1 1 1 4 296419 CS 65228 WHITE AAA PLAID SHORT 1 1 1 1 w 4� 7 `j 0 /00;00 RPC 8 1 UPS GROUND SERVICE Callaway Golf is a trademark of Callaway Golf Company. Ashworth, Inc., 2765 Loker Avenue 4Ves1. Carlsbad, CA X2008 is an Official Licensoe of Calla:vay Golf Company °age I 1'ACKSIJP Brookshire Golf Club Inventory Received Report 12120 Brookshire Parkway Order Number: 05112008 -16 Carmel, IN 46033 Order Number ItemCotle Description OrderedTo Date Receivetl Unit Cost ,Extendetl Extentled Da Received 3003170 CLWY MENS SHORTS 8 8 0 $28.58 $228.64 $0.00 .GrandTotals m8 _a 0 1 8 $2858 mT.$22864. Authorized by Date Order Number: 05112008 -16 Page 1 of 1 Prescribed 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)) d V2 7,? o Total 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 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 materials or services itemized thereon for OyV9� S600,6 7S which charge is made were ordered and 9�S 2 SO//6 SZ� received except 9 20 Od Sig ure Title Cost distribution ledger classification if claim paid motor vehicle highway fund